Experienced Claims Customer Service Advocate II – Insurance Claims Resolution and Customer Support

At careerzynith, we're dedicated to delivering exceptional service to our customers, and we're looking for a skilled Claims Customer Service Advocate II to join our team. As a Claims Customer Service Advocate II, you'll play a critical role in responding to customer inquiries, resolving complex claims, and upholding careerzynith's commitment to customer satisfaction.

• *Why Join careerzynith?**

For over seven decades, careerzynith has been a trusted name in the insurance industry, with a strong presence in the South Carolina community. As one of the nation's leading administrators of government contracts, we operate one of the most sophisticated data processing centers in the Southeast. Our diverse family of subsidiary companies allows us to build on a variety of business strengths, and we're committed to delivering outstanding service to our customers. If you share our philosophy and values, consider joining our team!

• *About the Role**

As a Claims Customer Service Advocate II, you'll be responsible for:

• Responding accurately, timely, and courteously to customer inquiries via telephone, written, web, or walk-in interactions
• Handling complex situations that require adaptation of response or extensive research
• Identifying incorrectly processed claims and processing adjustments and reprocessing actions according to department guidelines
• Examining and processing claims and/or non-medical appeals according to business/contract regulations, internal standards, and examining guidelines
• Entering claims into the claim system after verification of correct coding of procedures and diagnosis codes
• Ensuring claims are processing according to established quality and production standards

• *What You'll Need**

To succeed in this role, you'll need:

• 2 years of customer service experience, including 1 year of claims or appeals processing, or a Bachelor's Degree in lieu of work experience
• High School Diploma or equivalent
• Strong verbal and written communication skills
• Good spelling, punctuation, and grammar skills
• Basic business math proficiency
• Ability to handle confidential or sensitive information with discretion
• Microsoft Office proficiency

• *Our Work Environment**

As a Claims Customer Service Advocate II, you'll work in a typical office environment, Monday-Friday, with an 8-hour shift scheduled during our normal business hours of 8:00AM-5:00PM. You may be required to travel between buildings, and occasional overtime may be necessary.

• *Our Comprehensive Benefits Package**

At careerzynith, we're committed to supporting our employees' well-being and career growth. Our comprehensive benefits package includes:

• 401(k) retirement savings plan with company match
• Subsidized health plans and free vision coverage
• 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

• *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.

• *Equal Employment Opportunity Statement**

careerzynith 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. We're 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.

• *How to Apply**

If you're passionate about delivering exceptional customer service and resolving complex claims, we encourage you to apply for this exciting opportunity. Please submit your application through our website, and our recruiting team will review your qualifications.

• *Apply Now!**

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• *Contact Us**

If you need special assistance or an accommodation while seeking employment, please email [[email protected]](mailto:[email protected]) or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.

• *E-Verify and Pay Transparency Nondiscrimination Provision**

careerzynith participates in E-Verify and complies with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.

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