Claims Advocate
2 weeks ago
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:
- Respond to customer inquiries in a timely and courteous manner.
- Perform research to resolve customer inquiries and resolve issues.
- Review and adjudicate claims and/or non-medical appeals according to business/contract regulations and internal standards.
- Enter claims into the claim system after verification of correct coding of procedures and diagnosis codes.
- 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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