![CGS Administrators](https://media.trabajo.org/img/noimg.jpg)
Claims Customer Service Advocate I
1 week ago
We are hiring a Claims Customer Service Advocate I. In this role, you will be responsible for responding to routine inquiries. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions. Reviews and adjudicates claims and/or non-medical appeals. In addition, you will determine whether to return, deny or pay claims following organizational policies and procedures.
Description
Logistics
This position is full time (40 hours/week) Monday-Friday in a typical office environment. Employees will work 8:00 AM - 5:00 PM. This role is on site in Myrtle Beach, SC to Surfside location.
What You'll Do
- Responds to written and/or telephone inquiries according to desk procedures, ensuring that contract standards and objectives for timeliness, productivity, and quality are met. Accurately documents inquiries. Identifies incorrectly processed claims and processes adjustments and reprocessing actions according to department guidelines.
- Examines and processes claims and/or non-medical appeals according to business/contract regulations, internal standards and examining guidelines. Enters claims into the claim system after verification of correct coding of procedures and diagnosis codes. Ensures claims are processing according to established quality and production standards.
- Identifies complaints and inquiries of a complex level that cannot be resolved following desk procedures and guidelines and refers these to a lead or manager for resolution. Identifies and promptly reports and/or refers suspected fraudulent activities and system errors to the appropriate departments.
- High School Diploma or equivalent
- One (1) year of experience in a claims/appeals processing, customer service, or other related support area OR Bachelor's Degree in lieu of work experience.
- Good verbal and written communication skills.
- Strong customer service skills.
- Good spelling, punctuation, and grammar skills.
- Basic business math proficiency.
- Ability to handle confidential or sensitive information with discretion.
- Microsoft Office.
- C2 Clearance prior to starting.
- One (1) year of claims experience
You are not alone. We are here to support you:
Our comprehensive benefits package includes:
- 401(k) retirement savings plan with company match
- Subsidized health plans and free vision coverage
- Life insurance
- Paid annual leave - the longer you work here, the more you earn
- Nine paid holidays
- On-site cafeterias and fitness centers in major locations
- Wellness programs and healthy lifestyle premium discount
- Tuition assistance
- Service recognition
After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with a recruiter to verify resume specifics and salary requirements.
Management will be conducting interviews with the most qualified candidates, with prioritization given to those candidates who demonstrate the preferred qualifications.
We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.
Some states have required notifications. Here's more information.
Equal Employment Opportunity Statement
BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains Affirmative Action programs to promote employment opportunities for minorities, females, disabled individuals and veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.
We are committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities.
If you need special assistance or an accommodation while seeking employment, please e-mail or call , ext with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.
-
FCMB Claims Customer Service Advocate II
1 week ago
Myrtle Beach, South Carolina, United States BlueCross BlueShield of South Carolina Full timeWe are hiring a Claims Customer Service Advocate II In this role you will be responsible for responding to routine correspondence and telephone inquiries pertaining to claims or appeals. In addition, you will identify incorrectly processed claims an Customer Service, Claims, Advocate, Part Time, Processing, Service, Retail, Healthcare
-
FCMB Claims Customer Service Advocate II
1 week ago
Myrtle Beach, South Carolina, United States Palmetto GBA Full timeSummary We have an FCMB Customer Service Advocate II job opening at BlueCross BlueShield of South Carolina. In this position, your duties include responding to routine correspondence and telephone inquiries related to claims or appeals. You will be tasked with identifying inaccurately processed claims, completing adjustments, and taking steps to reprocess...
-
Seasonal: Guest Advocate
4 weeks ago
Myrtle Beach, South Carolina, United States Target Full timeStarting Hourly Rate / Salario por Hora Inicial: $15.00 USD per hourEffective, 05/19/2024 to 09/07/2024, all team members will be eligible to receive a temporary additional $1 added to their base pay.ALL ABOUT TARGETWorking at Target means helping all families discover the joy of everyday life. We bring that vision tolife through our values and culture.Learn...
-
Seasonal: Guest Advocate
1 month ago
Myrtle Beach, South Carolina, United States Target Full timeStarting Hourly Rate / Salario por Hora Inicial: $15.00 USD per hourEffective, 05/19/2024 to 09/07/2024, all team members will be eligible to receive a temporary additional $1 added to their base pay.ALL ABOUT TARGETWorking at Target means helping all families discover the joy of everyday life. We bring that vision tolife through our values and culture.Learn...
-
Customer Service Representative
1 week ago
Myrtle Beach, South Carolina, United States Circle K Stores, Inc. Full timeStore : 422 George Bishop Parkwy, Myrtle Beach, South Carolina 29579 Availability Shift/ Days Flexible Availability Customer Service Representative. We want you to join our team as a Customer Service Representative. If you have the desire to Customer Service Representative, Customer Service, Representative, Retail, Service
-
Customer Service Representative
1 week ago
Myrtle Beach, South Carolina, United States HomeTeam Pest Defense Full timeOverview At HomeTeam, we put people first . We make sure at HomeTeam you have the tools, support, and training to deliver a delightful experience to every customer. Our friendly, warm work environment means great work gets recognized and rewarded. If you take pride in going above and beyond to make a customer smile, you could be HomeTeam's next all-star...
-
Student Financial Services Specialist
4 weeks ago
Myrtle Beach, South Carolina, United States HCA Healthcare Full timeDescription IntroductionAre you passionate about delivering superior work outcomes? At Galen College of Nursing, we are committed to a single purpose: offering excellence in nursing education. Our staff and administration live out our vision We change the life of one to care for the lives of many. Jump-start your career as a Student Financial Services...
-
Student Financial Services Specialist
1 month ago
Myrtle Beach, South Carolina, United States HCA Healthcare Full timeDescription IntroductionAre you passionate about delivering superior work outcomes? At Galen College of Nursing, we are committed to a single purpose: offering excellence in nursing education. Our staff and administration live out our vision We change the life of one to care for the lives of many. Jump-start your career as a Student Financial Services...
-
Food Service Maintenance I
1 week ago
Myrtle Beach, South Carolina, United States Ocean Lakes Family Campground Full timeJob DescriptionJob DescriptionOcean Lakes Family Campground of Myrtle Beach, SC is actively seeking energetic and motivated Food Service Maintenance Technicians to join our team Are you mechanically inclined? Do you like working with your hands? Then this position may be perfect for youThis position includes excellent perks like getting PAID WEEKLY, flexible...
-
Myrtle Beach, South Carolina, United States Tidelands Health Full timeEmployee Type:RegularWork Shift:Day - 8 hour shift (United States of America)Join Team Tidelands and help people live better lives through better healthPosition Summary:The OP Rehabilitation Patient Services Assistant/Rehab Technician will perform administrative duties as it relates to clinical needs of patient care and the clinical staff. Daily, performs a...
-
Myrtle Beach, South Carolina, United States SunCoast Advertising Full timeJob Description Job Description Customer Care, Sales, and Marketing Associate Are you ready to embark on an extraordinary journey? SunCoast Advertising is seeking passionate individuals to join our team as Customer Care, Sales, and Marketing Associates. At SunCoast, we specialize in creating unforgettable experiences for our customers by blending exceptional...
-
Myrtle Beach, South Carolina, United States Myrtle Beach Pelicans Full timeJOB DUTIES: Receive duty assignments from the Manager and immediately report to that area. Set up area in accordance with guidelines which will be given to you by the Manager. Take and fill guest food and beverage orders. Maintain a friendly smile and an attentive attitude when dealing with guests and fellow employees. Assist in the safe, sanitary and timely...
-
Seasonal: Overnight Inbound
1 week ago
Myrtle Beach, South Carolina, United States Target Full timeStarting Hourly Rate / Salario por Hora Inicial: $15.00 USD per hourEffective, 05/19/2024 to 09/07/2024, all team members will be eligible to receive a temporary additional $1 added to their base pay.ALL ABOUT TARGETWorking at Target means helping all families discover the joy of everyday life. We bring that vision to life through our values and culture....
-
Pharmacy Grad Intern
1 month ago
Myrtle Beach, South Carolina, United States Walmart Full timeWhat you'll do atPosition Summary...What you'll do...Ensures compliance with Company and legal policies, procedures, and regulations for assigned areas by analyzing and interpreting reports, implementing and monitoring loss prevention and safety controls, overseeing safety, operational, and quality assurance reviews, and developing and implementing action...
-
Pharmacy Grad Intern
4 weeks ago
Myrtle Beach, South Carolina, United States Walmart Full timeWhat you'll do atPosition Summary...What you'll do...Ensures compliance with Company and legal policies, procedures, and regulations for assigned areas by analyzing and interpreting reports, implementing and monitoring loss prevention and safety controls, overseeing safety, operational, and quality assurance reviews, and developing and implementing action...
-
Supervisor - Guest Services
1 month ago
Myrtle Beach, South Carolina, United States The Caravelle Resort Full timeThe guest service supervisor supervises and trains guest service staff to have a high standard for guest delivery and efficient communication between all service staff. They ensure all guests are assisted with any complaints or service issues. As a supervisor, they must ensure that all forms and documents/printing going are accurate at all times and approved...
-
Supervisor - Guest Services
1 week ago
Myrtle Beach, South Carolina, United States The Caravelle Resort Full timeThe guest service supervisor supervises and trains guest service staff to have a high standard for guest delivery and efficient communication between all service staff. They ensure all guests are assisted with any complaints or service issues. As a supervisor, they must ensure that all forms and documents/printing going are accurate at all times and approved...
-
Community Manager, Onsite I
1 week ago
Myrtle Beach, South Carolina, United States AAM1 Full timePrimarily responsible for providing community management and effective customer service within a Homeowner's Association (HOA) community through in-depth knowledge of Governing Documents (CC&Rs) and compliance with all applicable State, City and County laws and regulations. Also responsible for identifying, coordinating, and marketing all social, wellness,...
-
Guest Services Manager in Training
1 month ago
Myrtle Beach, South Carolina, United States tapwage Full timeGuest Services Manager In Training:Responsibilities: Ensures Outstanding customer care at all times. Maintains a friendly, professional, cheerful and courteous demeanor at all times. Accurately answers inquiries from potential guests and accepts hotel reservations. Consistently resolves guest problems and complaints in an efficient manner while demonstrating...
-
Guest Services Manager in Training
4 weeks ago
Myrtle Beach, South Carolina, United States tapwage Full timeGuest Services Manager In Training:Responsibilities: Ensures Outstanding customer care at all times. Maintains a friendly, professional, cheerful and courteous demeanor at all times. Accurately answers inquiries from potential guests and accepts hotel reservations. Consistently resolves guest problems and complaints in an efficient manner while demonstrating...