FCMB Claims Customer Service Advocate II

Pay:
Competitive

Location:

Myrtle Beach/South Carolina

Employment Type:

Full-Time

• Req#: R1044281

Responsible for responding to routine correspondence and telephone inquiries pertaining to claims or appeals. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions.

Logistics: PGBA – a subsidiary of Blue Cross Blue Shield of South Carolina.

Location: This full-time position (40 hours/week, Monday-Friday) is based in a typical office environment. Flexibility in work hours is required within 8:00 AM – 5:00 PM. Training occurs Monday – Friday, 8:00 AM - 4:30/5:00 PM, for approximately 6-8 weeks. The role is on-site at 8733 Highway 17 Bypass, Myrtle Beach, SC 29575.

• Government Clearance: Ability to obtain a security clearance; U.S. citizenship is required.
• SCA Benefit Requirements: Enrolled in health insurance benefits within 28 days of hire as per the Service Contract Act (SCA).

• Research and respond to telephone inquiries, ensuring compliance with standards for timeliness, productivity, and quality.
• Respond to written inquiries, correct improperly processed claims, and complete necessary adjustments or reprocessing, including initiating recoupments.
• Identify and escalate complex issues and report potential fraud or abuse.
• Complete projects related to claims processing and customer service.

• Education: High School Diploma or equivalent.
• Experience: 2 years customer service OR 1 year claims/appeals processing and 1 year customer service OR a Bachelor's Degree.
• Skills: Good communication, customer service, spelling, punctuation, grammar, basic math, discretion handling sensitive info.
• Tools: Microsoft Office.

• Subsidized health, dental, vision
• 401K with match
• Life Insurance
• PTO
• On-site amenities
• Wellness programs
• Tuition assistance
• Recognition programs
• Employee Assistance
• Discounts

We value diversity and inclusion, offering opportunities for career development. The application review process includes potential interviews and verification steps. We are an equal opportunity employer and provide accommodations for disabilities and religious beliefs. For assistance, contact  or call , ext. 47480.

We participate in E-Verify and adhere to pay transparency laws. As South Carolina's only locally owned health insurer, we have served the community for over 70 years and are one of the state's largest employers.