Claims Customer Service Advocate II

Posted:
8/22/2024, 9:19:19 AM

Location(s):
Columbia, South Carolina, United States ⋅ South Carolina, United States

Experience Level(s):
Junior ⋅ Mid Level ⋅ Senior

Field(s):
Customer Success & Support

Workplace Type:
On-site


Summary
 

We are currently hiring for a Customer Service Advocate II to join BlueCross BlueShield of South Carolina. You will provide prompt, accurate, thorough and courteous responses to all complex customer inquiries. Inquiries are typically non-routine and require deviation from standard screens, scripts, and procedures. You will also perform research as needed to resolve inquiries, review and adjudicate complex or specialty claims and/or non-medical appeals; and determine whether to return, deny or pay claims following organizational policies and procedures.

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’ve 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 dedicated 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.


Description
 

Logistics:

This position is full time (40 hours/week) Monday-Friday in a typical office environment. Employees are required to have flexibility work any our 8-hour shift scheduled during hours of 8:00 AM – 6:00 PM. Training will be Monday – Friday 8:00 AM -4:30/5:00 PM for approximately 6-8 weeks. This role is located on-site at 4101 Percival Road, Columbia SC

What you will do:

  • Ensures effective customer relations by responding accurately, timely, and courteously to telephone, written, web, or walk-in inquiries. Handles situations which may require adaptation of response or extensive research. Accurately documents inquiries.
  • Initiates or processes adjustments or performs other research as needed to resolve inquiries. Coordinates with other departments to resolve problems. Responds to, research and/or assists with priority inquiries and special projects as required by management.
  • Provides feedback to management regarding customer problems, questions, and needs. Maintains accurate records on complaints and/or other customer comments and makes recommendations for changes to management. Follows through on complaints until resolved or reports to management as needed.
  • Maintains basic knowledge of quality work instructions and company policies. Assists with process improvements through the recommendation of changes in procedures and techniques discovered during daily operations. Maintains all departmental productivity, quality, and timeliness standards.
  • Assist with the training of new employees and cross training of coworkers.

What we prefer:

  • Associate Degree
  • 3-years of customer service or call center experience
  • Knowledge of word processing, spread sheet and database software.

To Qualify for this position, you will need:

  • High School Diploma or equivalent
  • 1 year of claims processing or customer service experience
  • Bachelor's Degree in lieu of work experience.
  • Excellent verbal and written communication skills.
  • Proficient spelling, punctuation, and grammar.
  • Strong human relations and organizational skills.
  • Ability to handle high stress situations. Good judgment.
  • Ability to handle confidential or sensitive information with discretion.
  • Ability to learn and operate multiple computer systems effectively and efficiently.
  • Basic computer operating skills.
  • Standard office equipment.

You are not alone. We are here to support you with:

  • Classroom and Lab Training
  • Best in class call center training program
  • A classroom environment, live trainer, and open discussion
  • 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

What We Can Do for You

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 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 a recruiter to verify resume specifics and salary requirements. 

Management will be conducting interviews with the most qualified candidates, with prioritization give 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.

Some states have required notifications. Here's more information

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 [email protected] or call 1-800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.