Summary
 

We are currently hiring for a Customer Service Advocate III to join BlueCross BlueShield of South Carolina. You will be responsible for providing prompt, accurate, thorough and courteous responses to all complex customer inquiries. Inquiries are typically non-routine and require deviation from standard screens, scripts, and procedures. Performs research as needed to resolve inquiries. Reviews and adjudicates complex or specialty claims and/or non-medical appeals. Determines whether to return, deny or pay claims following organizational policies and procedures.

Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation’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!

Here is your opportunity to join a dynamic team at a diverse company with secure, community roots and an innovative future.

Description
 

Logistics:

This position is full-time (40 hours/week) Monday-Friday in a W@H 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.

What You'll Do:

• Responsible for accurate and timely response to complex telephone, written, web, or walk-in inquiries. Handles situations which may require adaptation of response or extensive research. Maintain all departmental productivity, quality and timeliness standards.
• Initiate corrective actions, process adjustments, or perform other research to resolve inquiries. Evaluate inquiries to identify underlying causes and implement actions to prevent future issues. Coordinate with other departments to resolve problems.
• Provide feedback to management regarding customer issues. Maintain accurate records concerning issues. Follow through on complaints until resolved or report to management as needed.
• Maintain knowledge of procedures and policies. Assist with process improvements by recommending improvements in procedures and policies.
• Assist with the training of new employees and cross training of coworkers.

To Qualify for This Position, You'll Need:

• High School Diploma or equivalent
• 2 Years Customer service or claims processing experience OR Bachelor's Degree in lieu of work experience.
• Strong oral and written communication skills.
• Proficient in spelling, punctuation, and grammar.
• Strong organizational, analytical, and customer service skills.
• Ability to handle high stress situations. Basic business math proficiency.
• Ability to handle confidential or sensitive information with discretion.
• Ability to learn and operate multiple computer systems effectively and efficiently.
• Microsoft Office.

What we prefer:

• 3 Years-Customer service or claims processing experience.
• Experience with people with Autism
• Associate Degree-Any Major
• Ability to persuade, negotiate or influence.
• Knowledge of database software.