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FCMB Claims Customer Service Advocate II (Part-time)

Company: BlueCross BlueShield of South Carolina
Location: Myrtle Beach
Posted on: May 27, 2023

Job Description:

We are hiring a Claims Customer Service Advocate II! In this role you will be responsible for responding to routine correspondence and telephone inquiries pertaining to claims or appeals. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions.
This position is part time with availability to work Monday-Friday. This role is onsite in Myrtle Beach, SC
What You'll Do

  • Research 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.
    • Identify 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.
    • Complete projects and/or assignments related to claims processing and customer service functions in the department. To Qualify for this Position, You'll Need
      • High School Diploma or equivalent
      • Good oral and written communication skills.
      • Strong customer service skills.
      • Good spelling punctuation and grammar skills.
      • Basic math proficiency.
      • Ability to handle confidential and sensitive information with discretion.
      • Microsoft Office.
      • ADP level II government security clearance prior to start We Prefer That You Have
        • Two (2) years of customer service experience OR one (1) year of claims or appeals processing experience and one year of customer service experience OR bachelor's Degree in lieu of work experience.
        • Prior TRICARE experience. What We Can Do for You
          You are not alone. We are here to support you:
          Our comprehensive benefits package includes:
          • 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 healthy lifestyle premium discount
          • Tuition assistance
          • Service recognition
            What to Expect Next
            After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with a recruiter to verify resume specifics and salary requirements.
            We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.
            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 e-mail abilities@bcbssc.com or call 1-800-288-2227, ext. 43172 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.

Keywords: BlueCross BlueShield of South Carolina, Wilmington , FCMB Claims Customer Service Advocate II (Part-time), Hospitality & Tourism , Myrtle Beach, North Carolina

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