FCMB Claims Customer Service Advocate II

4 weeks ago


Myrtle Beach, United States Penn Foster Inc Full time

Summary As a Government Customer Service team member, you will be responsible for responding to routine correspondence and telephone inquiries on claims or appeals. Identify incorrectly processed claims and complete adjustments and related reprocessing actions. Logistics This position is on-site full-time Monday-Friday in a typical office environment. Employees are required to work from 8:00 AM to 5:00 PM. It may be necessary, given the business need to work occasional overtime and weekends. This role is located in Myrtle Beach, SC. Description Mandatory 3-month training program on site. Possibility of remote after training based upon performance. What You’ll Do: Research and respond to telephone inquiries according to desk procedures, ensuring that contract standards and objectives for timeliness, productivity, and quality are met. Research and respond to written inquiries, identify incorrectly processed claims, and complete the adjustment and/or reprocessing action according to department guidelines. This may include initiating, documenting, and processing the request to completion. Initiate recoupments as necessary. Identify complaints and inquiries of a complexity level that cannot be resolved following desk procedures and guidelines and refers these to a lead or manager for resolution. Identify and reports potential fraud and abuse situations. Complete projects and/or assignments related to the department's claims processing and customer service functions. The work environment is the typical office environment. You will be required to obtain a government (C-2) clearance. To Qualify for This Position, You’ll Need: High School Diploma or equivalent Two years of customer service experience OR One year of claims or appeals processing experience and one year of customer service experience OR a Bachelor's Degree in place of work experience. Answers phones Follows policies and procedures Navigates systems Processes claims Researches inquiries Reviews claims and appeals Microsoft Office knowledge What we prefer: TRICARE experience within the last two years. (May be concurrent with other experience.) What We Can Do For You: 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 a healthy lifestyle premium discount Tuition assistance Service Recognition What to Expect Next: 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 our recruiter to verify resume specifics and salary requirements. Management will conduct interviews with those candidates who qualify, with prioritization given to those candidates who demonstrate the preferred qualifications. #J-18808-Ljbffr



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