Customer Service Advocate II Part Time 4pm to 8pm

About the Role

Part-time Customer Service Advocate II position at PGBA, a BlueCross BlueShield of South Carolina subsidiary. Located on-site at 200 North Dozier Boulevard, Florence, SC 29501. Schedule: 20 hours/week, Monday–Friday, 4:00 pm–8:00 pm. Training: Monday–Friday, 8:00 am–4:30 pm for five weeks in a typical office environment. This position is not eligible for visa sponsorship.

Responsibilities

• Research and respond to telephone inquiries according to desk procedures, ensuring contract standards for timeliness, productivity, and quality are met.
• Research and respond to written inquiries; identify incorrectly processed claims and complete adjustments and/or reprocessing actions per department guidelines, including initiating, documenting, and processing requests to completion.
• Initiate recoupments as necessary.
• Identify complaints and inquiries that exceed desk-procedure complexity and refer them to a lead or manager for resolution.
• Identify and report potential fraud and abuse situations.
• Complete projects and/or assignments related to claims processing and customer service functions.

Requirements

Education

• High School Diploma or equivalent

Experience

• 2 years of customer service experience, OR
• 1 year of claims or appeals processing experience plus 1 year of customer service experience, OR
• Bachelor's Degree in lieu of work experience

Skills & 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

Software & Tools

• Microsoft Office

Work Environment

Typical office environment.

Company Culture

BlueCross BlueShield of South Carolina emphasizes a diverse and inclusive workplace where employees across all spectrums have the opportunity to develop skills, advance careers, and contribute unique abilities to the company's growth.