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FCMB Claims Customer Service Advocate II

BlueCross BlueShield of South Carolina
life insurance, paid time off, tuition assistance, 401(k)
United States, South Carolina, Columbia
May 21, 2025
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

Location:

This position is full-time (40 hours/week) Monday-Friday in a typical office environment. Employees are required to have flexibility work any our 8-hour shift scheduled during hours of 10AM-7PM. Training will be Monday - Friday 8:00 AM - 4:30/5:00 PM for approximately 6-8 weeks. This role is located on site at 4101 Percival Road, Columbia SC.

What You'll Do:

  • Researches and responds 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 completes 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.
  • Identifies complaints and inquiries of a complexity 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.
  • Completes projects and/or assignments related to claims processing and customer service functions in the department.

To Qualify for This Position, You'll Need the Following:

  • 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 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 for 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
  • Wellness program and healthy lifestyle premium discount
  • Tuition assistance
  • Service recognition
  • Employee Assistance
  • 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.

Management will conduct interviews with those candidates who qualify, with prioritization given to those candidates who demonstrate the required qualifications.

Equal Employment Opportunity Statement

BlueCross BlueShield 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 contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilitiesand protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.

If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.comor call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's moreinformation.

Some states have required notifications. Here's more information.

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