On-site Claims & Appeals Advocate II

Southcarolinablues; Columbia (SC); On-site; USD 42,000 - 66,000; Full time

Benefits offered by this job

On-site cafeterias

Fitness centers in major locations

401K retirement with company match

Paid Time Off (PTO)

Tuition assistance

Job summary

BlueCross BlueShield of South Carolina - Columbia, SC, seeks a Claims Customer Service Advocate II for on-site, full-time work. You will handle routine inquiries, process claims and appeals, verify coding, and ensure adherence to quality standards in a 40-hour week with 9am–6pm shifts.

Requirements include a high school diploma (or equivalent) and 1 year of claims/appeals processing or related experience; a bachelor’s degree can substitute for experience.

Qualifications

• Respond to routine inquiries and document accordingly.
• Identify incorrectly processed claims and perform adjustments.
• Explain claims/appeals procedures per contract guidelines.

Responsibilities

• Respond to written or telephonic inquiries in a timely manner.
• Document inquiries accurately and route complex items to a lead.
• Process claims and non-medical appeals per guidelines and regulations.
• Enter claims into the system after verifying codes.
• Identify potential fraud or system errors and report them.

Skills

Verbal & Written Communication

Customer Service

Spelling, Punctuation & Grammar

Basic Business Math

Confidential Information Handling

Education

High School Diploma or equivalent

Bachelor’s degree in lieu of experience

Tools

Microsoft Office

Job description

BlueCross BlueShield of South Carolina - Columbia, SC, seeks a Claims Customer Service Advocate II for on-site, full-time work. You will handle routine inquiries, process claims and appeals, verify coding, and ensure adherence to quality standards in a 40-hour week with 9am–6pm shifts.

Requirements include a high school diploma (or equivalent) and 1 year of claims/appeals processing or related experience; a bachelor’s degree can substitute for experience.