Claims Advocate

3 weeks ago

Florence, South Carolina, United States PGBA, LLC Full time
Job Summary

This role is responsible for providing timely and accurate assistance to customers regarding their health care questions and claims concerns. The successful candidate will work in a typical office environment, Monday-Friday, 8-hour shifts, with flexibility to work overtime and weekends as needed.


Key Responsibilities:
  • Proactively resolve members' and/or providers' questions and concerns using computer-based resources.
  • Guide members and providers with their healthcare needs by explaining benefits, solving claim concerns, and helping find a doctor via telephone calls, online chats, or written communication.
  • Accurately document these questions for the success of this role.

Requirements:

The ideal candidate will possess a High School Diploma or equivalent. Excellent verbal and written communication skills, including proficiency in spelling, grammar, and punctuation, are essential. Strong human relations and organizational skills, with a demonstrated ability to handle high-stress intense situations and conversations, are also required. Good judgment and the ability to handle confidential or sensitive information with discretion are necessary.


Preferred Qualifications:
  • 2 years of customer service experience or 1 year of claims or appeals processing experience and 1 year of customer service experience.
  • A bachelor's degree in lieu of work experience is preferred.

What We Offer:

We provide a comprehensive benefits package, including:

  • 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.

Salary:$45,000 - $65,000 per year.

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