FCMB Claims Customer Service Advocate II
BlueCross BlueShield Of South Carolina
- Myrtle Beach, SC
- Permanent
- Full-time
As a Government Customer Service team member, you will be responsible for responding to routine correspondence and telephone inquiries on claims or appeals. Identify incorrectly processed claims and complete adjustments and related reprocessing actions.Logistics
This position is on-site full-time Monday-Friday in a typical office environment. Employees are required to work from 8:00 AM to 5:00 PM. It may be necessary, given the business need to work occasional overtime and weekends. This role is located in Myrtle Beach, SC.DescriptionMandatory 3-month training program on site. Possibility of remote after training based upon performance.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, identify incorrectly processed claims, and complete 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.Identify and reports potential fraud and abuse situations.Complete projects and/or assignments related to the department's claims processing and customer service functions.The work environment is the typical office environment.You will be required to obtain a government (C-2) clearance.To Qualify for This Position, You’ll Need:High School Diploma or equivalentGood verbal and written communication skillsStrong customer service skillsGood spelling, punctuation and grammar skillsAbility to handle confidential or sensitive information with discretion.What we prefer:Two years of customer service experience OR One year of claims or appeals processing experience and one year of customer service experience OR a bachelor's degree in place of work experience.What We Can Do for You:Our comprehensive benefits package includes:401(k) retirement savings plan with company matchSubsidized health plans and free vision coverageLife insurancePaid annual leave - the longer you work here, the more you earn.Nine paid holidaysOn-site cafeterias and fitness centers in major locationsWellness programs and a healthy lifestyle premium discountTuition assistanceService RecognitionWhat 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 conduct interviews with those candidates who qualify, 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'sEqual Employment Opportunity StatementBlueCross 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.