Ourhrconnect
FCMB Claims Customer Service Advocate II
Columbia, South Carolina · Mid · Contract
No sponsorshipDetected 2 days ago
CybersecurityLogisticsCustomer SupportCommunicationClaims Management
About the role
- Summary 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.
- Description Logistics: PGBA - is a subsidiary company of BlueCross BlueShield of South Carolina.
Responsibilities
- Accurately documents inquiries.
- 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.
- Ability to Manage Confidential or Sensitive Information with Discretion.
Requirements
- Employees are required to have flexibility work any our 8-hour shift scheduled during hours of 9AM -6PM due to contractual obligations.
- This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen.
- 1-year of experience including 1-year claims/appeals processing, customer service, or other related support area OR bachelor's degree in lieu of work experience.
- Required Work Experience:
- Required Skills and Abilities:
- Required Software and Tools:
- We Prefer that you Have the Following:
Skills
- Good Verbal and Written Communication Skills
- Strong Customer Service Skills
- Good Spelling, Punctuation and Grammar Skills.
- Basic Business Math Proficiency.
- Microsoft Office.
- Associate degree
- (2) years-of claims processing or call center experience.
- Knowledge of word processing, spreadsheet, and database software.
- Subsidized health plans, dental and vision coverage
- 401K retirement savings plan with company match
- Life Insurance
- Paid Time Off (PTO)
Compensation
- This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.
Benefits
- Examines and processes claims and/or non-medical appeals according to business/contract regulations, internal standards and examining guidelines.
- Required Education:
- Our comprehensive benefits package includes the following:
- We offer our employees great benefits and rewards.
- You will be eligible to participate in the benefits the first of the month following 28 days of employment.
- Wellness program and healthy lifestyle premium discount
- Tuition assistance
Company info
- PGBA - is a subsidiary company of BlueCross BlueShield of South Carolina.
Equal opportunity
- 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 individuals with disabilities and protected 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 disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.
Visa & Work Authorization
- This position is not eligible for sponsorship now or in the future.
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This listing is sourced directly from Ourhrconnect's careers page and normalized into a canonical job model.