Claims Customer Service Advocate I
Southcarolinablues
- # Claims Customer Service Advocate IApply: On-site: Columbia, South Carolina: Full time: Posted Today: End Date: October 13, 2026 (3 days left to apply): R1051349# **Summary**Responsible for responding to routine inquiries. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions. Reviews and adjudicates claims and/or non-medical appeals. Determines whether to return, deny or pay claims following organizational policies and procedures.# **Description****Logistics:**PGBA – is a subsidiary company of BlueCross BlueShield of South Carolina.**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 8:00 AM –5:00 PM. 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 17 Technology Circle, Columbia SC* **Government Clearance:** This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen.* **SCA Benefit Requirements**: BlueCross BlueShield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act *(*SCA*).* **Under the McNamara-O'Hara Service Contract Act (SCA), employees are required to enroll in health insurance benefits regardless of other insurance coverage. Employees will receive supplemental pay until they are enrolled in health benefits 28 days after the hire date.****Sponsorship**: This position is not eligible for sponsorship now or in the future**What You’ll Do:*** Responds to written and/or telephone inquiries according to desk procedures, ensuring that contract standards and objectives for timeliness, productivity, and quality are met. Accurately documents inquiries. Identifies incorrectly processed claims and processes adjustments and reprocessing actions according to department guidelines.* Examines and processes claims and/or non-medical appeals according to business/contract regulations, internal standards and examining guidelines. Enters claims into the claim system after verification of correct coding of procedures and diagnosis codes. Ensure claims are processed according to established quality and production standards.* Identifies complaints and inquiries of a complex level that cannot be resolved following desk procedures and guidelines and refers these to a lead or manager for resolution. Identifies and promptly reports and/or refers suspected fraudulent activities and system errors to the appropriate departments.**To Qualify for This Position, You’ll Need the Following:*** **Required Education**:* High School Diploma or equivalent* **Required Work Experience:*** 1 year of experience in claims/appeals processing, customer service, or other related support area **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, and you will be contacted via the application portal if selected for scheduling.**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 disabilities and 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 View email address on click.appcast.io or call View phone number on click.appcast.io 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 more information.
- J-18808-Ljbffr Southcarolinablues
Vacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the Claims Customer Service Advocate I in Brooklyn, NY vacancy
$25.75 per hour
Title Customer Care Advocate Department Customer Service Union OPEIU Grade 16 Position Summary The Customer Care Advocate provides customer service to participants... ..., and providers regarding eligibility, benefits, and claims status. "Has minimum necessary access to Protected...ClaimsLocal area- The Customer Care Advocate provides customer service to participants, beneficiaries, union locals, and providers regarding eligibility, benefits, and claims status. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information...ClaimsLocal area
$48k - $52k
...Description POSITION TITLE: Family Advocate SALARY RANGE : $48,000 - $52,... ...of Intervention MDT & Family Services FLSA STATUS: Full time (40... ...Services (OVS) compensation claim applications. Responsible for... ...AND ABILITIES Outstanding customer service, interpersonal communication...ClaimsFull timeWork at officeFlexible hoursCacgroc
Brooklyn, NY1 day ago- ...support daily operations, grow client relationships, and ensure smooth service delivery. You will act as a liaison between customers and agency departments, handling policy changes, inquiries, and claims in a fast-paced office. The role emphasizes teamwork, coaching, and...ClaimsWork at office
$20 per hour
...finances and insurance with patients, and able to follow through on outstanding claims and patient accounts. This is a patient-facing role where excellent communication and customer service are just as important as accuracy and follow-through. Key Responsibilities...ClaimsHourly payFull timeDental Art Concepts PLLC
Staten Island, NY16 days ago- ...the world to help serve our valued customers. In this remote Healthcare Advocate role , you'll take as many as 50 -... ..., on the first call, customer service inquires and issues by identifying... ...such as benefits, eligibility and claims, financial spending accounts and correspondence...ClaimsFull timeWork experience placementSeasonal workRemote workWork from homeFlexible hoursShift work
TaskUs
Brooklyn, NY8 hours ago - Sun Life U.S. is seeking an Insurance Claims Advocate to join the ICAT team. This non-exempt role delivers expert medical billing advocacy and insurance claims resolution, supporting members through all advocacy products. You will investigate unpaid or denied claims, coordinate...ClaimsWork at office
- ...to facilitate patient access, reduce delays, prevent avoidable claim denials, and support the financial health of the department. Responsibilities... ...authorization or referral requirements apply to scheduled services. Obtain, initiate, or facilitate insurance authorizations when...Claims
eBanqo Inc
Brooklyn, NY2 days ago $45k - $100k
...their dreams. We are located in Queens, NY and help customers with their insurance and financial services needs, including:Auto insuranceHome insuranceLife insuranceRetirement... ...with policy changes and inquiries.Process insurance claims and follow up with customers on claim status....ClaimsAriel Abreu
Corona, NY1 day ago- Sedgwick Claims Management Services Ltd. invites applications for a Care Team Representative with afternoon/evening shifts in Memphis and other... ...first-contact service for claims, document calls, and guide customers through the process in a supportive, hybrid in-office/...ClaimsWork at officeRemote workAfternoon shift
- ...health insurance benefits and coverage. You will support claims, coordinate program resources, and advocate for fair treatment with providers while... ...stakeholders. This role emphasizes clear communication, empathy, and service excellence. #J-18808-Ljbffr Lewer CompaniesClaims
$19 per hour
...looking for a Patient Financial Advocate to join our growing team and... ...(PFA) provides outstanding service to patients with billing inquiries... ..., their bill and claims processing, payment options,... ...Meet productivity, quality, and customer service standards Other projects...ClaimsFull timeRemote work- Description The Patient Advocate is responsible for effectively managing the billing cycle for assigned client site(s) by working the 4 C’s: Charges, Claims, Cash, and Collections to achieve Gold Standard Results. Accountable for reviewing charges for accuracy, submitting...ClaimsDaily paidWork at officeFlexible hours
$35k - $50k
...vital to our daily business operations and customers' success. You grow our agency through... ...proactively marketing relevant products and services. Grow your career as you better your... ...changes and inquiries. Process insurance claims and follow up with customers on claim...ClaimsFor contractorsWork at officeDean Zupo - State Farm Agent
Brooklyn, NY2 days ago$22 per hour
...for an accommodation or an alternative application process. Customer Support Advocate Indianapolis, IN, US 3 days ago Requisition ID: 1430 We are... ..., and professional customer support Assist with product, service, and technical-related questions Troubleshoot customer issues...Hourly payPart time- Moffitt Cancer Center is seeking a Patient Relations Service Representative to staff the information desks, delivering high-quality in-person and phone customer service to cancer center patients, guests, and staff. You will be the first point of contact, ensuring a welcoming...Part time
- Precision Human Resource Solutions, Inc. seeks a Call Center Customer Service Representative for an in-office role with CREC in Hartford, CT. The position starts immediately and requires working in a crowded call center environment. Hours include 12:30pm-7:30pm or 5:30...Work at officeImmediate startMonday to Friday
- Titlemax in Lewisville, TX is seeking a Customer Service Representative (Bilingual) to assist customers with in-store transactions, provide personalized financial services, and maintain accurate customer records in our POS system. This entry-level role includes hands-on...Full timeWeekend work
- Scott Richardson Agency is a State Farm Agent team seeking a Customer Service Representative in Ames, IA. This full-time role focuses on delivering exceptional service, handling inquiries, maintaining records, and building strong relationships with community members. You...Full time
$19 per hour
We're looking for Customer Advocates with at least 2 years of customer-facing experience to build an exciting career at Carvana - the fastest-growing used automotive retailer in U.S. history and one of the four fastest companies to make the Fortune 500! Whether it's delivering...Hourly paySummer workLocal areaShift workWeekday work- Bass Pro Shops in Bristol, TN is seeking a CLUB Customer Service Associate (Seasonal) to deliver world-class service and promote CLUB membership. You will act as the product expert, process payments, and guide customers through CLUB applications. The role emphasizes customer...Part timeSeasonal work
- Partnership HealthPlan of California in California is seeking a Customer Service Representative to respond to member and provider inquiries in the call center, document interactions, and assist with enrollment tasks. This role emphasizes strong communication, empathy,...
- Safelite Group in Warwick, RI is seeking a Customer Advocate to greet customers, handle calls and emails, and process work orders and invoicing... ..., verify information, and support payments while maintaining service excellence in a busy setting. A high school diploma and 1-3...
- River Valley Co-op in Easthampton, MA is seeking a Temporary Customer Service Team Member to warmly welcome shoppers, process in-store and online orders, and support daily operations. The role requires open availability, including evenings and weekends; candidates should...Temporary workShift workWeekend workAfternoon shift
- Walgreens Co. is hiring in Northfield, MN to assist pharmacists under supervision and deliver excellent customer service. You will work at the register, help customers find products, and support pharmacy operations including prescription processing and inventory control...Flexible hoursAfternoon shift
- Mom’s Meals is seeking upbeat Customer Service Representatives in Des Moines, IA to be the first friendly voice for customers placing meal orders. The role requires a high school degree and 1 year of customer service experience, with training in CRM systems and HIPAA policies...Weekly payMonday to Friday
- ...CEHQcurrently has an excitingCustomerSuccess Advocate opportunity| Raleigh, NC or Carrollton,... ...companies that sell, deliver and service Carrier, Bryant & Payne products to residences... ...in their respective markets. CE offers customers a wide range of HVAC/R product lines,...Hourly payFull timeTemporary workPart timeFor contractorsWork at officeRemote work
$20 per hour
We're looking for Customer Advocates with at least 2 years of customer-facing experience to build an exciting career at Carvana - the fastest-growing used automotive retailer in U.S. history and one of the four fastest companies to make the Fortune 500! Whether it's delivering...Hourly payLocal areaShift workWeekday work$16 - $20 per hour
...and transformation-driven BPM services with decades of healthcare... ...solutions, payment integrity, claims cost containment, and analytics... .... Work At Home-Credentialing Advocate Job Description: Elevate Your... ...Thinking Time Management Customer Service Orientation Integrity...ClaimsDaily paidTemporary workWork at officeWork from homeFlexible hours$40k - $60k
...vital to our daily business operations and customers’ success. You help grow our office... ...proactively marketing relevant products and services. RESPONSIBILITIES Manage customer... ...changes and inquiries. Process insurance claims and follow up with customers on claim status...ClaimsFull timeFor contractorsWork at officeFlexible hoursTroupinsurance
Brooklyn, NY2 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Claims Customer Service Advocate I. Be the first to apply!
Related searches
- advocate Brooklyn, NY
- housing advocate Brooklyn, NY
- client advocate Brooklyn, NY
- member advocate Brooklyn, NY
- customer success advocate Brooklyn, NY
- customer care advocate Brooklyn, NY
- domestic violence advocate Brooklyn, NY
- health advocate Brooklyn, NY
- family advocate Brooklyn, NY
- victim advocate Brooklyn, NY