Experienced Claims Customer Service Advocate II – Insurance Claims Resolution and Customer Experience Expert

Are you passionate about delivering exceptional customer experiences and navigating complex insurance claims processes? Do you thrive in a dynamic, fast-paced environment where no two days are the same? Look no further than arenaflex, a leading insurance company with a rich history and commitment to innovation. We're seeking an experienced Claims Customer Service Advocate II to join our team, where you'll play a critical role in resolving customer inquiries, processing claims, and upholding the highest standards of customer service.

Why Join arenaflex?

At arenaflex, we're more than just an insurance company – we're a community-driven organization with a legacy of excellence spanning over seven decades. As the largest insurance company in South Carolina, we've built a reputation for delivering outstanding service to our customers. Our diverse family of subsidiary companies allows us to leverage a range of business strengths, from data processing to government contracts. We're proud to operate one of the most sophisticated data processing centers in the Southeast, and we're committed to innovation and growth.

Logistics and Work Environment

This Claims Customer Service Advocate II role will be based at our Columbia, SC location, with training hours from 8:00 a.m. to 4:30 p.m., Monday through Friday. After training, you'll work a standard schedule of 8:00 a.m. to 6:00 p.m., Monday through Friday. Our state-of-the-art facilities offer on-site cafeterias and fitness centers, providing a comfortable and supportive work environment.

Key Responsibilities:

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

• Ensuring effective customer relations by responding accurately, timely, and courteously to telephone, written, web, or walk-in inquiries
• Handling situations that may 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 processed according to established quality and production standards
• Identifying complaints and inquiries of a complex level that cannot be resolved following desk procedures and guidelines and referring these to a lead or manager for resolution
• Identifying and reporting potential fraud and abuse situations

Qualifications:

To succeed in this role, you'll need:

• A High School Diploma or equivalent
• Two years of customer service experience, including one year of claims or appeals processing, or a Bachelor's Degree in lieu of work experience
• 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

Preferred Qualifications:

While not required, we prefer candidates with:

• One year of call center experience with claims experience

What We Can Offer:

At arenaflex, we're committed to supporting your career growth and well-being. As a Claims Customer Service Advocate II, you'll enjoy:

• 401K retirement savings plan with company match
• Subsidized health plans, dental, and vision coverage
• Life Insurance
• Paid Time Off (PTO)
• On-site cafeterias and fitness centers in major locations
• Wellness program and healthy lifestyle premium discount
• Tuition assistance
• Service recognition
• Employee Assistance
• Discounts to movies, theaters, zoos, theme parks, and more

What to Expect Next:

After submitting your application, our recruiting team 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 the most qualified candidates, prioritizing those who demonstrate the preferred qualifications.

Equal Employment Opportunity Statement:

arenaflex 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 physical and mental disabilities. If you need special assistance or an accommodation while seeking employment, please email [email protected] or call 1-800-288-2227, ext. 47480 with the nature of your request. We'll make a determination regarding your request for reasonable accommodation on a case-by-case basis.

Apply Now:

Ready to join our dynamic team and take your career to the next level? Apply now by clicking the link below: Apply Job! Apply for this job