8 Claims Customer Service Advocate II Jobs in Myrtle, SC
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Claims Customer Service Advocate II
$56k-67k (estimate)
Full Time | Insurance
1 Week Ago
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PGBA, LLC is Hiring a Claims Customer Service Advocate II Near Myrtle, SC
SummaryResponsible for responding to routine correspondence and telephone inquiries pertaining to claims or appeals. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions.
DescriptionLogistics:This position is full-time (40 hours/week) Monday-Friday in a typical office environment. Employees are required to have the flexibility to work any of our 8-hour shift scheduled during our normal business hours. It may be necessary, given the business need to work occasional overtime and weekends. This role is located at 8733 Highway 17 Bypass, Florence, South Carolina 29575 United States of America.What You'll Do
Our Comprehensive Benefits Package Includes
Management will be conducting interviews with the most qualified candidates, with prioritization given to those candidates who demonstrate the preferred qualifications.
We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.
Some states have required notifications. Here's more information.
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 mycareer.help@bcbssc.com or call 1-800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.
DescriptionLogistics:This position is full-time (40 hours/week) Monday-Friday in a typical office environment. Employees are required to have the flexibility to work any of our 8-hour shift scheduled during our normal business hours. It may be necessary, given the business need to work occasional overtime and weekends. This role is located at 8733 Highway 17 Bypass, Florence, South Carolina 29575 United States of America.What You'll Do
- Research and respond 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.
- Completes projects and/or assignments related to claims processing and customer service functions in the department.
- High School Diploma or equivalent
- Two years of customer service experience OR
- One year of claims or appeals processing experience and One year of customer service experience OR Bachelor's Degree in lieu of work experience.
- You will also have and be able pass a Government Clearance background as well as standard BlueCross BlueShield background.*
- TRICARE experience within the last two years. (May be concurrent with other work experience,.)
- Answers phones
- Follows policies and procedures
- Navigates systems
- Processes claims
- Researches inquiries
- Reviews claims and appeals
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 a healthy lifestyle premium discount
- Tuition assistance
- Service Recognition
Management will be conducting interviews with the most qualified candidates, with prioritization given to those candidates who demonstrate the preferred qualifications.
We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.
Some states have required notifications. Here's more information.
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 mycareer.help@bcbssc.com or call 1-800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.
Job Summary
JOB TYPE
Full Time
INDUSTRY
Insurance
SALARY
$56k-67k (estimate)
POST DATE
06/21/2024
EXPIRATION DATE
06/27/2024
WEBSITE
pgba.com
HEADQUARTERS
COLUMBIA, SC
SIZE
1,000 - 3,000
FOUNDED
2002
CEO
MIKE SKARUPA
REVENUE
$200M - $500M
INDUSTRY
Insurance
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