Description
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 4101 Percival Road, Columbia, SC 29229.
What You'll 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.
- Identifies incorrectly processed claims and processes adjustments and reprocessing actions according to department guidelines.
- Examines and processes claims and / or non-medical appeals according to business / contract regulations, internal standards and examining guidelines.
- Enters claims into the claim system after verification of correct coding of procedures and diagnosis codes.
- Ensures claims are processing according to established quality and production standards.
- 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.
- Identifies and reports potential fraud and abuse situations.
To Qualify for This Position, You'll Need :
- Two years of customer service experience including One year claims or appeals processing OR
- Bachelor's Degree in lieu of work experience.
- High School Diploma or equivalent
- 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.
What we prefer :
P rovider Customer Service Experience
Work Environment :
Typical office environment.
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 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.
Claims Customer Service Advocate II
Title: Claims Customer Service Advocate II. Required Education: High School Diploma or equivalent Required Work Experience: 2 years of customer service experience including 1 year claims or appeals processing OR Bachelor's Degree in lieu of work experience. Skill sets/qualities: Medical background, ...
Claims Customer Service Advocate Ii
Strong customer service skills. Responsible for responding to customer inquiries. Reviews and adjudicates claims and/or non-medical appeals. Determines whether to return, deny or pay claims following organizational policies and procedures. ...
Customer Service Advocate II
Required Education: High School Diploma or equivalent Required Work Experience: 2 Years Customer service or claims processing experience OR Bachelor's Degree in lieu of work experience. Strong organizational, analytical, and customer service skills. Preferred Education: Associate Degree-Any Major Pr...
Claims Customer Service Advocate II
Two years of customer service experience including One year claims or appeals processing. Strong customer service skills. Ensures effective customer relations by responding accurately, timely, and courteously to telephone, written, web, or walk-in inquiries. Identifies incorrectly processed claims a...
Customer Service Advocate I
Strong customer service skills. Required Education: High School Diploma or equivalent Required Work Experience: None Preferred Education: Associate Degree Preferred Work Experience: 2 years-of customer service or call center experience. Provides prompt, accurate, thorough and courteous responses to ...
Customer Service Advocate Iii
Strong organizational, analytical, and customer service skills. Provides prompt, accurate, thorough and courteous responses to all complex customer inquiries. Provide feedback to management regarding customer issues. ...
Claims Customer Service Advocate III
Reviews claims or appeals issues, complaints, and inquiries referred by claims customer service representatives to determine if desk procedures and guidelines were followed. Assists in training claims customer service representatives. Strong customer service skills. Researches and responds to comple...
Customer Service Advocate I & II
We're seeking Customer Service Representatives to work at the largest employers in South Carolina. What's a typical day as a Customer Service Professional? You'll be:. Have strong customer service skills. Apply to be a Customer Service Professional today!. ...
Claims Customer Service Advocate I
Title: Claims Customer Service Advocate I. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions. Reviews and adjudicates claims and/or non-medical appeals. Determines whether to return, deny or pay claims following organizational policies and procedures....
Claims Customer Service Professional
How about this one?* We’re seeking Claims Customer Service Advocates to work at an amazing company in Columbia, SC. Strong customer service skills. Why you should apply to be a Customer Service Professional:** Working for a great company* Getting back to work in a safe environment* Access to outstan...