FCMB Customer Service Advocate II
FCMB Customer Service Advocate II
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Job Description
Summary
We are currently hiring for a Claims Customer Service Advocate II to join BlueCross BlueShield of South this role as a Claims Customer Service Advocate II you will be responsible for helping 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 customers questions are answered correctly the first time.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 have 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 nations 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 committed 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
Position Purpose:
From the moment of login youll 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.
Logistics: PGBA
Location: 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 29501 United States of America.
- SCA Benefit Requirements: BlueCross BlueShield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act (SCA). 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.
What Youll Do:
- 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.
To Qualify for This Position Youll Need the Following:
- Required Education: High School Diploma or equivalent
- Required Work Experience: 2 years of customer service experience OR 1 year of claims or appeals processing experience and 1 year of customer service experience OR Bachelors Degree in lieu of work experience.
- Required Skills and Abilities: 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.
- Required Software and Other Tools: Microsoft Office.
- Work Environment: Typical office environment.
We Prefer That You Have The Following:
- 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.
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.
- Subsidized health plans dental and vision coverage
- 401k retirement savings plan with company match
- Life Insurance
- Paid Time Off (PTO)
- On-site cafeterias and fitness centers in major locations
- Education Assistance
- Service Recognition
- National discounts to movies theaters zoos theme parks and more
What We Can Do for You:
We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills advance their careers and contribute their unique abilities to the growth of our company.
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 individuals with disabilitiesand 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.
If you need special assistance or an accommodation while seeking employment please email or call 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.
We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Heres moreinformation.
Some states have required notifications. Heres more information.
Employment Type
Full-Time
