FCMB Claims Customer Service Advocate II (

Company: Blue Cross Blue Shield companies
Location: Florence
Posted on: March 18, 2023

Job Description:

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 Position Purpose This role directly helps our customers in a timely, prompt, and accurate way to answer some of their most worrisome health care questions and claims concerns. This job can be complex and may require research as well as the ability to feel comfortable going off-script to ensure our customer's questions are answered correctly the first time. 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 200 North Dozier Boulevard Florence, SC 29501United States of America. What You'll Do: From the moment of login, you'll be focused on proactively resolving our members' and/or providers' questions and concerns using computer-based resources to find answers. Communication via telephone, written, web, or walk-in inquiries. You will guide members and providers with their healthcare needs by explaining benefits, solving claim concerns, and helping find a doctor via telephone calls, online chats, or e-mails. At times extensive research may be needed and it may be necessary to collaborate with other departments to find the answers needed. Accurately documenting these questions is vital for the success of this role. You are the subject matter expert for this role. Your leadership team is open to your recommendations, feedback, process improvements, and assistance with special projects to make positive changes for the department. Once you have mastered this role, training and sharing your knowledge with new team members can be a rewarding part of this role. To Qualify for This Position, You'll Need: A High School Diploma or equivalent. Excellent verbal and written communication skills including proficiency in spelling, grammar, and punctuation. Strong human relations and organizational skills, with a demonstrated ability to handle high-stress intense situations and conversations. Good judgment and the ability to handle confidential or sensitive information with discretion. Ability to learn We Prefer That You Have: 2 years of customer service experience or 1 year of claims or appeals processing experience and 1 year of customer service experience or a bachelor's degree in lieu of work experience is preferred. What We Can Do For You: You are not alone. We are here to support you: Six weeks of training including: * Best-in-class call center training program * Peer coach to observe you * Peer coach for you to observe * Open discussion conversations * A proven curriculum providing the knowledge you need to excel * A training lab where you take live calls with a training supervisor close by to answer questions 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 What 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 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. 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 abilities@bcbssc.com or call 1-800-288-2227, ext. 43172 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.

Keywords: Blue Cross Blue Shield companies, Fayetteville , FCMB Claims Customer Service Advocate II (, Other , Florence, North Carolina