Ourhrconnect
Claims Customer Service Advocate II
Columbia, South Carolina · Mid · Contract
No sponsorshipDetected 20 hours ago
LogisticsCustomer SupportResearchCommunicationMicrosoft Office
About the role
- Summary Responsible for responding to customer inquiries.
- Inquiries may be non-routine and require deviation from standard screens, scripts, and procedures.
- Reviews and adjudicates claims and/or non-medical appeals.
Responsibilities
- 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.
Requirements
- Employees are required to have flexibility to work any of our 8-hour scheduled shifts during the hours of 8am-8pm.
- 2 years of customer service experience including 1 year of claims or appeals processing experience OR Bachelor's Degree in lieu of work experience.
- Required Work Experience:
- Required Skills and Abilities:
- Required Software and Tools:
- We Prefer 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.
- Ability to handle confidential or sensitive information with discretion.
- Microsoft office
- Experience researching and processing Coordination of Benefits Claims.
- National Alliance experience preferred.
- Subsidized health plans, dental and vision coverage
- 401K retirement savings plan with company match
- Life Insurance
- Paid Time Off (PTO)
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
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.