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Claims Customer Service Advocate I

4 months ago

Columbia, United States Experis Full time

Our client, Health care industry is seeking a Claims Customer Service Advocate  to join their team. 

 

Job Title: Claims Customer Service Advocate 

Location: Columbia , SC

Pay Range: $16/hr on w2

 

Key Responsibilities:

  • Inquiry Response (40%):
    • Respond to written and telephone inquiries according to established desk procedures.
    • Ensure that all responses meet contract standards for timeliness, productivity, and quality.
    • Accurately document all inquiries and identify incorrectly processed claims.
    • Process adjustments and reprocessing actions in accordance with departmental guidelines.
  • Claims and Appeals Processing (40%):
    • Examine and process claims and non-medical appeals following business/contract regulations and internal standards.
    • Verify correct coding of procedures and diagnosis codes before entering claims into the system.
    • Ensure claims are processed according to established quality and production standards.
  • Issue Resolution (20%):
    • Identify complex complaints and inquiries that cannot be resolved using standard procedures and guidelines.
    • Refer these issues to a lead or manager for resolution.
    • Promptly report suspected fraudulent activities and system errors to the appropriate departments.

Preferred Skills:

  • Experience in claims processing
  • Excellent time-management skills
  • Ability to work independently
  • Strong research skills
  • Effective communication skills
  • Dependability and reliability

Day-to-Day Activities:

  • Assist with batching and opening mail.
  • Key claims as needed.
  • Process deferred claims.
  • Participate in new project initiatives with ample training provided.
  • Collaborate with team members to find solutions and provide feedback.
  • Engage in an open-door policy environment encouraging feedback and continuous improvement.

Training and Work Environment:

  • Training provided onsite for 6-8 weeks.
  • Position is not remote; onsite work is required after training.

Why Join Us:

  • Be part of a new and growing project with numerous opportunities for career growth.
  • Engage in a supportive team environment where collaboration and feedback are encouraged.

Application Process:

If this is a role that interests you and you’d like to learn more, click apply now and a recruiter will be in touch with you to discuss this great opportunity. We look forward to speaking with you

 

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.