Praneeth Patlola
This listing was posted on Willhire.
Claims Customer Service Advocate I
Location:
Columbia
Description:
<p>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. Business and political climates may change, but we’re stronger than ever. Our A.M. Best rating is A+ (Superior) — making us the only health insurance company in South Carolina with that rating. We’re 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!</p><p><strong>Position Notes:</strong></p><ul><li>Not SCA Eligible</li><li>Contract to Perm</li><li>40 hrs/wk; 7:30am - 4:00 pm (Monday-Friday)</li><li>Interviews In person</li><li><strong>Training onsite 6-8 weeks; position is not remote after training.</strong></li><li><strong>Onsite ONLY</strong></li><li>Preferred Skills:</li><li>Claims experience; time-management skills; ability to work independently; research skills. Communication skills; dependability; time-management; ability to work independently. Day to Day: Assist with batching and opening the mail; keying claims as needed; process deferred claims. Starting a new project so everything is new to everyone, ample training with many opportunities for growth. We lean on one another to find solutions and answers as needed; open door policy and always looking for feedback from each other.</li></ul><p>Job Title: <strong>Claims Customer Service Advocate I</strong></p><p><strong>Duties:</strong></p><ul><li>Responsible for responding to routine inquiries</li><li>Identifies incorrectly processed claims and completes adjustments and related reprocessing actions</li><li>Reviews and adjudicates claims and/or non-medical appeals</li><li>Determines whether to return, deny or pay claims following organizational policies and procedures</li><li>40% Responds to written and/or telephone inquiries according to desk procedures, ensuring that contract standards and objectives for timeliness, productivity, and quality are met</li><li>Accurately documents inquiries. Identifies incorrectly processed claims and processes adjustments and reprocessing actions according to department guidelines</li><li>40% Examines and processes claims and/or non-medical appeals according to business/contract regulations, internal standards and examining guidelines</li><li>Enters claims into the claim system after verification of correct coding of procedures and diagnosis codes</li><li>Ensures claims are processing according to established quality and production standards</li><li>20% 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</li><li>Identifies and promptly reports and/or refers suspected fraudulent activities and system errors to the appropriate departments</li></ul><p><strong>Skills:</strong></p><ul><li>High School Diploma or equivalent</li><li>1 year of experience in a claims/appeals processing, customer service, or other related support area OR Bachelor's Degree in lieu of work experience</li><li>Good verbal and written communication skills</li><li>Strong customer service skills</li><li>Good spelling, punctuation and grammar skills</li><li>Basic business math proficiency. Ability to handle confidential or sensitive information with discretion</li><li>Required Software and Other Tools: Microsoft Office</li></ul><p>This is the pay range that Magnit reasonably expects to pay someone for this position is <strong>$12.00/hour - $16.00/hour</strong>. Benefits: Medical, Dental, Vision, 401K (provided minimum eligibility hours are met). </p><p>BlueCross is a strong supporter of our veterans, and many service men and women have joined our ranks. We’ve found the dedication, work ethic and job skills that serve well in the military excel in many of our lines of business, and we proudly have veterans filling positions in Human Resources, Information Technology, Customer Service, Operations, General Services and more. </p><p>Through our government contracts, we also have employees serving at Shaw Air Force Base, the Naval Health Clinic in Charleston, the Naval Hospital in Beaufort and in our hometown of Columbia, S.C., at Ft. Jackson. If you are a full-time employee in the National Guard or Reserves, we will even cover the difference in your pay if you are called to active duty. If you're ready to join in a diverse company with secure, community roots and an innovative future, apply for a position now!</p>
Education/experience:
1 To 2 Years
Company:
Bluecross Blueshield Of South Carolina
Posted:
May 6 on Willhire
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More About this Listing: Claims Customer Service Advocate I
Claims Customer Service Advocate I is a Customer Service Customer Service Representative Job at Bluecross Blueshield of South Carolina located in United States. Find other listings like Claims Customer Service Advocate I by searching Oodle for Customer Service Customer Service Representative Jobs.
Claims Customer Service Advocate I is a Customer Service Customer Service Representative Job at Bluecross Blueshield of South Carolina located in United States. Find other listings like Claims Customer Service Advocate I by searching Oodle for Customer Service Customer Service Representative Jobs.