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BlueCross BlueShield of South Carolina · 2 days ago

FCMB Customer Service Advocate II

Florence, SC

Full-time

Onsite

Entry Level

2+ years exp

BlueCross BlueShield of South Carolina is seeking a Customer Service Advocate II to address member and provider inquiries regarding claims and appeals. The role involves researching and resolving questions, documenting interactions, and collaborating with other departments to ensure quality service delivery.

Financial ServicesHealth CareHealth InsuranceInsuranceMedical

Responsibilities

Researches and responds to telephone inquiries according to desk procedures, ensuring that contract standards and objectives for timeliness, productivity, and quality are met

Research and respond to written inquiries and identify incorrectly processed claims and completes the adjustment and/or reprocessing action according to department guidelines. This may include initiating, documenting, and processing the request to completion. Initiate recoupments as necessary

Identifies complaints and inquiries of a complexity level that cannot be resolved following desk procedures and guidelines and refers these to a lead or manager for resolution. Identifies and reports potential fraud and abuse situations

Completes projects and/or assignments related to claims processing and customer service functions in the department

Qualification

Customer serviceClaims processingMicrosoft OfficeBusiness mathJudgmentVerbal communicationWritten communicationOrganizational skills

Required

High School Diploma or equivalent

2 years of customer service experience OR 1 year of claims or appeals processing experience and 1 year of customer service experience OR Bachelor's Degree in lieu of work experience

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

Microsoft Office

Preferred

Strong human relations and organizational skills, with a demonstrated ability to handle high-stress intense situations and conversations

Good judgment and the ability to handle confidential or sensitive information with discretion

Ability to learn

Benefits

Subsidized health plans, dental and vision coverage

401k retirement savings plan with company match

Life Insurance

Paid Time Off (PTO)

On-site cafeterias and fitness centers in major locations

Education Assistance

Service Recognition

National discounts to movies, theaters, zoos, theme parks and more

Company

BlueCross BlueShield of South Carolina

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For more than six decades, BlueCross BlueShield of South Carolina has been part of the national landscape. Our roots are firmly embedded in the state.

Founded in 1946

Columbia, South Carolina, USA

10001+ employees