LanceSoft, Inc. ยท 1 month ago
Claims Customer Service Advocate II
Myrtle Beach, SC
Full-time, Contract
Onsite
Entry, Mid Level
$23.11/hr - $23.11/hr
2+ years expLanceSoft, Inc. is seeking a Claims Customer Service Advocate II to support Tricare East. The role involves responding to customer inquiries, reviewing and adjudicating claims, and ensuring effective customer relations while adhering to organizational policies and procedures.
Information Technology
Responsibilities
Ensures effective customer relations by responding accurately, timely, and courteously to telephone, written, web, or walk-in inquiries. Handles situations which may require adaptation of response or extensive research. Identifies incorrectly processed claims and processes adjustments and reprocessing actions according to department guidelines
Examines and processes claims and/or non-medical appeals according to business/contract regulations, internal standards and examining guidelines. Enters claims into the claim system after verification of correct coding of procedures and diagnosis codes. Ensures claims are processing according to established quality and production standards
Identifies complaints and inquiries of a complex 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
Qualification
Required
High School Diploma or equivalent
2 years of customer service experience including 1-year claims or appeals processing 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
Required Software and Other Tools: Microsoft Office
Benefits
Potential for conversion to FTE
Training will be 6 weeks onsite
Company
LanceSoft, Inc.
Established in 2000, LanceSoft is a pioneer in delivering top-notch Global Workforce Solutions and IT Services to a diverse clientele.
5001-10000 employees
H1B Sponsorship
LanceSoft, Inc. has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (55)
2024 (32)
2023 (23)
2022 (25)
2021 (60)
2020 (80)
Funding
Current Stage
Late StageLeadership Team
Ram Karuppusamy
Chairman & CEO
Simon Dealy
Chief Financial Officer
Company data provided by crunchbase