FCMB Claims Customer Service Advocate II ( Myrtle Beach)

Logistics: This position is full time (40 hours/week) Monday-Friday from 8:00am - 5:30pm EST and will be on-site in Myrtle Beach, SC. Mandatory 3-month training program will be on-site with the possibility of remote work after training based upon performance.

• 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 cannot opt out of health benefits. Employees will receive supplemental pay until they are enrolled in health benefits 28 days after the hire date.

What You Will Do:

• Research and respond 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, identify incorrectly processed claims, and complete 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.

• Identify 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.

• Identify and reports potential fraud and abuse situations.

• Complete projects and/or assignments related to the department's claims processing and customer service functions.

• The work environment is the typical office environment.

• You will be required to obtain a government (C-2) clearance.

To Qualify for This Position, You Will Need:

• High School Diploma OR equivalent.

• Good verbal and written communication skills.

• Strong customer service skills

• Good spelling, punctuation, and grammar skills

• Ability to handle confidential or sensitive information with discretion.

We Prefer That You Have the Following:

• Two years of customer service experience OR One year of claims or appeals processing experience and one year of customer service experience OR a bachelor's degree in place of work experience.

Our comprehensive benefits package includes the following:

We offer our employees great benefits and rewards. You will be eligible to participate in the benefits 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

• 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.