Claims Customer Service Advocate II

2 days ago


West Columbia, South Carolina, United States PGBA Full time
Job Summary

We are seeking a highly skilled Claims Customer Service Advocate II to join our team at BlueCross BlueShield of South Carolina. As a key member of our customer service team, you will be responsible for providing exceptional service to our customers by resolving complex claims and inquiries in a timely and accurate manner.

Key Responsibilities
  • Respond to complex customer inquiries and resolve claims in a prompt and accurate manner.
  • Perform research and analysis to resolve claims and inquiries.
  • Review and adjudicate complex or specialty claims and/or non-medical appeals.
  • Determine whether to return, deny or pay claims following organizational policies and procedures.
  • Ensure effective customer relations by responding accurately, timely, and courteously to telephone, written, web, or walk-in inquiries.
Requirements
  • Two years of customer service experience including One year claims or appeals processing OR Bachelor's Degree in lieu of work experience.
  • High School Diploma or equivalent.
  • Good verbal and written communication skills.
  • Strong customer service skills.
  • Good spelling, punctuation and grammar skills.
  • Basic business math proficiency.
  • Ability to handle confidential or sensitive information with discretion.
Preferred Qualifications
  • Provider Customer Service Experience.
Work Environment
  • Typical office environment.
What We Offer
  • 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.
Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains Affirmative Action programs to promote employment opportunities for minorities, females, disabled individuals and veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need special assistance or an accommodation while seeking employment, please email or call, ext with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.



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