Customer Support

• Responds to customer inquiries via telephone, written, web, or walk-in inquiries
• Performs research as needed to resolve inquiries
• Reviews and adjudicates claims and/or non-medical appeals
• Determines whether to return, deny or pay claims following organizational policies and procedures
• Enters claims into the claim system after verification of correct coding of procedures and diagnosis codes
• Ensures claims are processing 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 reports potential fraud and abuse situations
• Location: On-site at 4101 Percival Road, Columbia SC; Full-time schedule with 8-hour shifts 8:00 AM–8:00 PM; Training 8:00 AM - 4:30 PM for ~6-8 weeks

Claims Customer Service Advocate II - Hybrid

Retail Loss Prevention Associate II

Financial Support Specialist

Customer Service Support Representative – Client Billing

Claims Support Representative

Pharmaceutical Support Specialist