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Claims Customer Service Advocate II

4 weeks ago

Columbia, United States Experis Full time

Job Title: Claims Customer Service Advocate 
Location: 4101 Percival Road Columbia SC 29229 United States 
Duration: 6 months contract
Pay Rate: $16/hr (On W2)

We are looking for a Claims Customer Service Advocate I to join one of our Fortune 500 clients.
Education &Qualifications:

  • High School Diploma or equivalent
  • 2 years of customer service experience including 1 year claims or appeals processing OR Bachelor's Degree in lieu of work experience
Responsibility
  • 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. Determines whether to return, deny or pay claims following organizational policies and procedures.
  • 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.

We are looking for the candidate who are eligible to work with any employers without sponsorship.

If you’re interested, please click “Apply” button.
If you are not available or this job is not a good fit at present, please share the job details with your friends/colleagues and let me know if anyone is interested.

 

About ManpowerGroup, Parent Company of:  Manpower, Experis, Talent Solutions, and Jefferson Wells

ManpowerGroup® (NYSE: MAN), the leading global workforce solutions company, helps organizations transform in a fast-changing world of work by sourcing, assessing, developing, and managing the talent that enables them to win. We develop innovative solutions for hundreds of thousands of organizations every year, providing them with skilled talent while finding meaningful, sustainable employment for millions of people across a wide range of industries and skills. Our expert family of brands – Manpower, Experis, Talent Solutions, and Jefferson Wells – creates substantial value for candidates and clients across more than 75 countries and territories and has done so for over 70 years. We are recognized consistently for our diversity - as a best place to work for Women, Inclusion, Equality and Disability and in 2022 ManpowerGroup was named one of the World's Most Ethical Companies for the 13th year - all confirming our position as the brand of choice for in-demand talent.

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