Claims Customer Service Advocate

Claims Customer Service Advocate

We at Kelly® hear you, and we're here for you! We're seeking a Claims Customer Service Advocate II to work at a leading healthcare organization in Myrtle Beach, SC. Sound good? Take a closer look below. You owe it to yourself to consider this great new opportunity.

Salary/Pay Rate/Compensation: $17.75 per hour

Shift: 8:00am to 5:00 PM

Credit Check REQUIRED

Why you should apply to be Claims Customer Service Advocate II:

• Competitive pay rate with opportunities for overtime.
• Work with a reputable organization in the healthcare industry.
• Gain experience in claims processing and customer advocacy.
• Positive, professional work environment focused on growth and development.
• Opportunity to expand your expertise in customer service and healthcare claims.

What's a typical day as Claims Customer Service Advocate II? You'll be:

• Responding to customer inquiries via phone, written correspondence, web, or in-person, including non-routine inquiries requiring deviation from standard procedures.
• Researching and resolving customer inquiries to ensure effective and timely resolutions.
• Reviewing and adjudicating claims and/or non-medical appeals, determining whether to return, deny, or pay claims in alignment with organizational policies.
• Processing claims adjustments and reprocessing actions following department guidelines.
• Entering claims into the system after verifying correct coding of procedures and diagnosis codes.
• Ensuring claims are processed according to quality and production standards.
• Referring complex complaints and inquiries to a lead or manager when necessary.
• Identifying and reporting potential fraud and abuse situations.

This job might be an outstanding fit if you:

• Have previous experience in customer service, preferably in a healthcare or insurance environment.
• Are comfortable handling complex inquiries and performing research to resolve issues.
• Possess strong communication skills and a commitment to providing courteous, accurate, and timely responses.
• Demonstrate attention to detail and the ability to follow department guidelines and procedures.
• Are able to identify and escalate issues appropriately.
• Are available to work 1st shift hours.

Once you apply, you'll proceed to next steps if your skills and experience look like a good fit. But don't worry—even if this position doesn't work out, you're still in our network. That means all of our recruiters will have access to your profile, expanding your opportunities even more. Helping you discover what's next in your career is what we're all about, so let's get to work.

Apply to be Claims Customer Service Advocate II today!