We have a job opening for the position of FCMB Customer Service Advocate II at BlueCross BlueShield of South Carolina. In this position, your duties include responding to routine correspondence and telephone inquiries related to claims or appeals. You will be tasked with identifying inaccurately processed claims, completing adjustments, and taking steps to reprocess them accordingly.
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 have 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 committed to the same philosophy, consider joining our team!
Here is your opportunity to join a dynamic team at a diverse company with secure, community roots and an innovative future.
Logistics:
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 Myrtle Beach, SC 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 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 complex level that cannot be resolved follow desk procedures and guidelines and refer these to a lead or manager for resolution.
· Identify and report potential fraud and abuse situations.
· Complete projects and/or assignments related to claim processing and customer service functions in the department.
To Qualify for This Position, You'll Need:
· High School Diploma or equivalent
· 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.
· Microsoft Office.
What We Prefer
· 2 years of customer service experience OR 1 year of claims or appeals processing experience and 1 year of customer service experience OR Bachelor's Degree in lieu of work experience. support.
Job Type: Full-time
Pay: From $17.20 per hour
Expected hours: No less than 40 per week
Benefits:
- 401(k)
- 401(k) 6% Match
- Employee assistance program
- Employee discount
- Parental leave
- Retirement plan
- Tuition reimbursement
Schedule:
- 8 hour shift
- Monday to Friday
Work setting:
Experience:
- Microsoft Office: 1 year (Preferred)
- Customer service: 2 years (Required)
Ability to Commute:
- Myrtle Beach, SC 29575 (Preferred)
Ability to Relocate:
- Myrtle Beach, SC 29575: Relocate before starting work (Required)
Work Location: In person