FCMB Claims Customer Service Advocate II; Part-time

Position: FCMB Claims Customer Service Advocate II (Part-time)
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** Summary
* * Responsible for responding to routine correspondence and telephone inquiries pertaining to claims or appeals. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions.#
** Description
* *** Logistics** - PGBA one of Blue Cross Blue Shield's South Carolina subsidiary companies.
*
* Location:

** This position is part-time (20 hours/week) Monday, Tuesday, Thursday and Friday from 12PM-5PM and will be on-site in Myrtle Beach, SC.
* ** Government Clearance**:
This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen.
* ** SCA Benefit Requirements**:
Blue Cross Blue Shield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act (SCA).
** Under the McNamara-O'Hara Service Contract Act (SCA), employees cannot opt out of health benefits. Employees will receive supplemental pay until they are enrolled in health benefits 28 days after the hire date.
***
* What You Will Do:

*** Research and respond 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 complete 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.
* Identify complaints and inquiries of a complexity level that cannot be resolved following desk procedures and guidelines and refer these to a lead or manager for resolution. Identifies and reports potential fraud and abuse situations.
* Complete projects and/or assignments related to claims processing and customer service functions in the department.
** To Qualify For This Position, You Will Need:**
* ** 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 Bachelor's 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.
** 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.
** 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.
** Equal Employment Opportunity Statement
** Blue Cross Blue Shield 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…