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FCMB Claims Customer Service Advocate II

BlueCross BlueShield of South Carolina
United Statesfull_timeVerifiedPosted 30 Jan 2025

About the role


Summary
 

This role directly helps our customers in a timely, prompt, and accurate way to answer some of their most worrisome health care questions and claims concerns. This job can be complex and may require research as well as the ability to feel comfortable going off-script to ensure our customer's questions are answered correctly the first time.


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 200 North Dozier Boulevard Florence, SC 29501 United States of America.

What You'll Do:

From the moment of login, you'll be focused on proactively resolving our members' and/or providers' questions and concerns using computer-based resources to find answers. Communication via telephone, written, web, or walk-in inquiries. You will guide members and providers with their healthcare needs by explaining benefits, solving claim concerns, and helping find a doctor via telephone calls, online chats, or e-mails. At times extensive research may be needed and it may be necessary to collaborate with other departments to find the answers needed. Accurately documenting these questions is vital for the success of this role. You are the subject matter expert for this role. Your leadership team is open to your recommendations, feedback, process improvements, and assistance with special projects to make positive changes for the department. Once you have mastered this role, training and sharing your knowledge with new team members can be a rewarding part of this role.

To Qualify for This Position, You'll Need:

A High School Diploma or equivalent. Excellent verbal and written communication skills including proficiency in spelling, grammar, and punctuation. Strong human relations and organizational skills, with a demonstrated ability to handle high-stress intense situations and conversations. Good judgment and the ability to handle confidential or sensitive information with discretion. Ability to learn.

We Prefer That You Have:

2 years of customer service experience or 1 year of claims or appeals processing experience and 1 year of customer service experience or a bachelor's degree in lieu of work experience is preferred.

What We Can Do for You:

You are not alone. We are here to support you:

Six weeks of training including:

  • Best-in-class call center training program.
  • Peer coach to observe you.
  • Peer coach for you to observe.
  • Open discussion conversations.
  • A proven curriculum providing the knowledge you need to excel.
  • A training lab where you take live calls with a training supervisor close by to answer questions.

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

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Company

BlueCross BlueShield of South Carolina

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