Customer Service Advocate II Part Time

Position: Customer Service Advocate II Part Time 2-6
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** SCA Benefit Requirements:
** Blue Cross Blue Shield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act (SCA). As a Service Contract Act (SCA) employee, you are required to enroll in our health insurance, even if you already have other health insurance. Until your enrollment is complete, you will receive supplemental pay for health coverage.

Your coverage begins on the first day of the month following 28 days of full-time employment**.
*** 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.
* ** 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 Other Tools:
** Microsoft Office.
* ** Work Environment:
** Typical office environment.
* Strong human relations and organizational skills, with a demonstrated ability to handle high-stress intense situations and conversations.
* Good judgment and the ability to handle confidential or sensitive information with discretion. Ability to learn.
* 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
* Education Assistance
* Service Recognition
* National discounts to movies, theaters, zoos, theme parks and more

PGBA, LLC is a leading provider of administrative services for the TRICARE health benefit program and health benefit programs of Veteran’s Health Administration for both state and federal governments. The company has offices in Florence, Surfside Beach, and Columbia, South Carolina.

PGBA employees work in an atmosphere that is conducive to growth and on that fosters a focus on personal and professional development with an environment made up of people from different parts of the world with diverse cultural Excellent benefits, as well as a competitive compensation program, make us one of the leading employers in today’s corporate market.
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