pWhy should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades wersquo;ve been part of the national landscape, with our roots firmly embedded in the South Carolina community. Business and political climates may change, but wersquo;re stronger than ever. Our A.M. Best rating is A+ (Superior) mdash; making us the only health insurance company in South Carolina with that rating. Wersquo;re the largest insurance company in South Carolina hellip;and much more. We are one of the nationrsquo;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!/ppJob Title:nbsp;Claims Customer Service Advocate… II/ppstrongPosition Details:nbsp;/strong/pulliWork Schedule: Monday thru Friday, 8:00 AM – 4:30 PM./liliTraining 6 weeks onsite – No option for Remote./liliLooking for medical background, office experience, customer service, previous call center experience./liliCandidate will handle provider service calls, responding and answering any questions providers may have. Must have previous customer service and call center experience.nbsp;/liliTeam is comprised of 17 people and the entire department has 80, close nit team environment./li/ulpstrongDuties:/strong/pulliResponsible for responding to customer inquiries./liliInquiries may be non-routine and require deviation from standard screens, scripts, and procedures./liliPerforms research as needed to resolve inquiries. Reviews and adjudicates claims and/or non-medical appeals./liliDetermines whether to return, deny or pay claims following organizational policies and procedures./lili45% 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./lili45% 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./lili10% 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./li/ulpstrongRequired Skills and Abilities:/strong/pulliRequired Education: High School Diploma or equivalent./liliRequired Work Experience: 2 years of customer service experience including 1 year claims or appeals processing OR Bachelor#39;s Degree in lieu of work experience./liliGood verbal and written communication skills./liliStrong customer service skills./liliGood spelling, punctuation and grammar skills./liliBasic business math proficiency./liliAbility to handle confidential or sensitive information with discretion./liliRequired Software and Other Tools: Microsoft Office./liliWork Environment: Typical office environment./li/ulpThis is the pay range that Magnit reasonably expects to pay someone for this position isnbsp;strong$12.00/hour – $16.00/hour/strong. Benefits:nbsp;Medical, Dental, Vision, 401K (provided minimum eligibility hours are met)./ppBlueCross is a strong supporter of our veterans, and many service men and women have joined our ranks. Wersquo;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.nbsp;/ppThrough 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.nbsp;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.nbsp;If you#39;re ready to join in a diverse company with secure, community roots and an innovative future, apply for a position now!/p
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