Claims Advocate

2 weeks ago


Columbia, South Carolina, United States Spectraforce Technologies Full time
Job Title: Claims Customer Service Advocate II

Location: Columbia, SC

Duration: 5+ months assignment

Shift: Mon-Fri 7:45 am-4:15pm

Job Summary:

We are seeking a highly skilled Claims Customer Service Advocate II to join our team at Spectraforce Technologies. As a Claims Customer Service Advocate II, you will be responsible for responding to customer inquiries, performing research to resolve inquiries, and reviewing and adjudicating claims and/or non-medical appeals.

Key Responsibilities:

  1. Respond to customer inquiries in a timely and courteous manner.
  2. Perform research to resolve customer inquiries and resolve issues.
  3. Review and adjudicate claims and/or non-medical appeals according to business/contract regulations and internal standards.
  4. Enter claims into the claim system after verification of correct coding of procedures and diagnosis codes.
  5. Ensure claims are processed according to established quality and production standards.

Requirements:

  • 2 years of customer service experience including 1 year claims or appeals processing.
  • High School Diploma or equivalent.
  • Strong customer service skills and good verbal and written communication skills.
  • Ability to handle confidential or sensitive information with discretion.

Work Environment:

Typical office environment.

Software and Tools:

Microsoft Office.


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