Claims Customer Service Advocate II
3.
8 North Charleston, SC North Charleston, SC Full-time Full-time From $16 an hour From $16 an hour 13 days ago 13 days ago 13 days ago Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we've been part of the national landscape, with our roots firmly embedded in the South Carolina community.
We are the largest insurance company in South Carolina and much more.
We are one of the nation's leading administrators of government contracts.
We operate one of the most sophisticated data processing centers in the Southeast.
We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths.
We deliver outstanding service to our customers.
If you are dedicated to the same philosophy, consider joining our team! Logistics:
Position is in our Charleston, SC office.
This is a work from home opportunity.
Work hours are 8 a.
m.
to 4:
30 p.
m.
Monday thru Friday, with some overtime.
What you will do:
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.
What you need to qualify:
Two years of customer service experience 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.
Good spelling, punctuation and grammar skills.
What we prefer you have:
Prior healthcare office or insurance experience.
What We Can Do for You:
We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have access and opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.
Our comprehensive benefits package includes:
401(k) retirement savings plan with company match Fantastic 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 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 our recruiter to verify resume specifics and salary requirements.
Management will be conducting interviews with the most qualified candidates.
Job Type:
Full-time Pay:
From $16.
00 per hour Expected hours:
40 per week
Benefits:
401(k) 401(k) 6% Match 401(k) matching Dental insurance Employee assistance program Employee discount Flexible spending account Health insurance Health savings account Life insurance Paid time off Professional development assistance Tuition reimbursement Vision insurance Schedule:
8 hour shift Work setting:
In-person Office
Experience:
Claims Processing:
1 year (Preferred) Ability to Relocate:
North Charleston, SC 29405:
Relocate before starting work (Required) Work Location:
In person.
Estimated Salary: $20 to $28 per hour based on qualifications.
8 North Charleston, SC North Charleston, SC Full-time Full-time From $16 an hour From $16 an hour 13 days ago 13 days ago 13 days ago Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we've been part of the national landscape, with our roots firmly embedded in the South Carolina community.
We are the largest insurance company in South Carolina and much more.
We are one of the nation's leading administrators of government contracts.
We operate one of the most sophisticated data processing centers in the Southeast.
We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths.
We deliver outstanding service to our customers.
If you are dedicated to the same philosophy, consider joining our team! Logistics:
Position is in our Charleston, SC office.
This is a work from home opportunity.
Work hours are 8 a.
m.
to 4:
30 p.
m.
Monday thru Friday, with some overtime.
What you will do:
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.
What you need to qualify:
Two years of customer service experience 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.
Good spelling, punctuation and grammar skills.
What we prefer you have:
Prior healthcare office or insurance experience.
What We Can Do for You:
We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have access and opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.
Our comprehensive benefits package includes:
401(k) retirement savings plan with company match Fantastic 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 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 our recruiter to verify resume specifics and salary requirements.
Management will be conducting interviews with the most qualified candidates.
Job Type:
Full-time Pay:
From $16.
00 per hour Expected hours:
40 per week
Benefits:
401(k) 401(k) 6% Match 401(k) matching Dental insurance Employee assistance program Employee discount Flexible spending account Health insurance Health savings account Life insurance Paid time off Professional development assistance Tuition reimbursement Vision insurance Schedule:
8 hour shift Work setting:
In-person Office
Experience:
Claims Processing:
1 year (Preferred) Ability to Relocate:
North Charleston, SC 29405:
Relocate before starting work (Required) Work Location:
In person.
Estimated Salary: $20 to $28 per hour based on qualifications.
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