Claims Customer Service Advocate –

Our client in Columbia, SC is looking for hardworking, motivated talent to join their team.

• Pay Rate: 15.00 an hour + benefits
• Onsite
• 3-6 Month Contract to Hire
• Full time
• Opportunity for growth / Mon-Fri, 8 AM - 4:30PM or 8:30 AM - 5 PM Schedule

Looking for a Claims Customer Service Advocate:
This position is responsible for responding to customer inquiries. Inquiries may be non-routine, require deviation from standard screens, scripts, and procedures. Performing research, as needed, to resolve inquires. Reviewing and adjudicating claims and/or non-medical appeals. Determines whether to return, deny, or pay claims following organizational policies and procedures.
45% of position is spent ensuring effective customer relations by responding accurately, timely, and courteously through telephone, written, web, and/or walk-in inquiries. Handling situations which may require adaption of response or extensive research. Identifying incorrectly processed claims and processes adjustments and reprocessing actions according to department guidelines.
45% is spend examining/processing claims and/or non-medical appeals according to business/contract regulations, internal standards, and examining guidelines. Entering claims into claim system after verification of correct coding of procedures and diagnosis codes. Ensuring claims are processed according to established quality and production standards.
10% is spent identifying complaints and inquires of a complex level that cannot be responded following desk procedures and guidelines and refers these to a lead or manager for resolution. Identifying and reporting potential fraud and abuse situations.

Requirements:
High School Diploma/GED plus 2 years of customer service experience, including 1 year of claims/appeals processing
OR
Bachelor degree in lieu of work experience
Good verbal/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
Strong knowledge of Microsoft Office suite: Outlook, Word, Excel, PowerPoint

Additional Benefits:

• Medical, Dental, Vision, 401k
• Weekly pay with direct deposit
• Consultant Care support
• Free Training to upgrade your skills
• Dedicated Career Partner to help you achieve your career goals