R1050365 Customer Service Advocate II Part Time 4pm-8pm

BlueCross BlueShield of South Carolina•Florence, SC

1d•Onsite

About The Position

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. This position is Part Time Monday-Friday (20 hours max) in a typical office environment. As a Service Contract Act (SCA) employee, you are required to enroll in our health insurance, even if you already have other health insurance. Until your enrollment is complete, you will receive supplemental pay for health coverage. Your coverage begins on the first day of the month following 28 days of full-time employment.

Requirements

High School Diploma or equivalent
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.
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.

Nice To Haves

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.

Responsibilities

Researches and responds 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 completes 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.
Identifies 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.
Identifies and reports potential fraud and abuse situations.
Completes projects and/or assignments related to claims processing and customer service functions in the department.