Senior Claims Customer Service Advocate II – arenaflex – Myrtle Beach, SC (Government Contracts)
About arenaflex – A Legacy of Trust, Innovation, and Community Impact
For more than seventy‑five years, arenaflex has stood as a pillar of reliability and excellence in the health insurance industry, deeply rooted in the communities we serve across the Southeast. As the largest insurer in South Carolina and a leading administrator of federal government contracts, we combine robust data‑driven operations with a heartfelt commitment to members, partners, and employees. Our flagship data processing center is among the most sophisticated in the region, and our diversified family of subsidiaries empowers us to deliver tailored solutions that meet evolving health and wellness needs.
At arenaflex, we believe that our people are the engine of our success. We foster an inclusive, collaborative environment where every voice matters, professional growth is celebrated, and innovative thinking is rewarded. If you thrive in a dynamic setting that blends meticulous service with cutting‑edge technology, you’ve found your next career home.
Position Overview – Claims Customer Service Advocate II (Myrtle Beach, SC)
We are seeking a motivated and detail‑oriented Claims Customer Service Advocate II to join our Government Customer Service team at the arenaflex Myrtle Beach location. In this pivotal role, you will serve as a frontline liaison, handling telephone and written inquiries related to claims and appeals, identifying and correcting processing errors, and ensuring compliance with contractual standards.
This is a full‑time, on‑site position (40 hours per week, Monday–Friday, 8:00 am–5:30 pm EST) with a comprehensive three‑month training program. Outstanding performance during training may open pathways to remote work arrangements.
Key Responsibilities
- Customer Interaction: Answer inbound telephone calls and respond to written correspondence in accordance with established desk procedures, maintaining adherence to timeliness, productivity, and quality benchmarks.
- Claims Review & Adjustment: Investigate claims that have been incorrectly processed, initiate appropriate adjustments or re‑processing actions, and document each step to ensure a transparent audit trail.
- Recoupment Initiation: Identify overpayments or erroneous disbursements and initiate recoupment actions where applicable.
- Escalation Management: Recognize complex issues that exceed standard desk authority, and promptly refer these cases to a lead or manager for resolution.
- Fraud & Abuse Detection: Remain vigilant for signs of potential fraud or abuse, documenting and reporting suspicious activity in line with department policies.
- Project Participation: Contribute to departmental projects and special assignments that aim to improve claims processing efficiency and customer satisfaction.
- Compliance & Clearance: Obtain and maintain a government (C‑2) security clearance, ensuring all activities meet federal contract requirements.
Essential Qualifications
- High School Diploma or equivalent (GED acceptable).
- Exceptional verbal and written communication skills, with a focus on clarity and professionalism.
- Demonstrated strong customer service orientation and ability to handle high‑volume interactions.
- Excellent spelling, punctuation, and grammar; capable of drafting clear, error‑free correspondence.
- High degree of discretion when handling confidential or sensitive information.
- U.S. citizenship (required for government security clearance).
Preferred Qualifications & Experience
- Two (2) years of professional customer service experience, preferably within a health‑care or insurance setting.
- One (1) year of experience processing claims or appeals combined with at least one (1) year of customer service experience.
- Bachelor’s degree in Business Administration, Health Services, or a related field – may substitute for work experience.
- Familiarity with government contract regulations, especially the Service Contract Act (SCA), and the ability to navigate associated benefit requirements.
- Prior experience obtaining or maintaining a government security clearance.
Core Skills & Competencies for Success
- Analytical Acumen: Ability to dissect complex claim data, spot discrepancies, and implement corrective actions efficiently.
- Problem‑Solving: Proactive approach to resolving customer issues, with a knack for turning challenges into positive experiences.
- Attention to Detail: Meticulous documentation and adherence to procedural guidelines to ensure compliance and auditability.
- Technology Proficiency: Comfortable using claim management systems, Microsoft Office Suite, and other enterprise software tools.
- Time Management: Skilled at prioritizing tasks and managing workload in a fast‑paced environment.
- Team Collaboration: Works well with cross‑functional teams, including claims processors, managers, and IT support.
Compensation, Benefits & Perks
arenaflex offers a competitive salary package complemented by a comprehensive benefits suite designed to support the health, financial security, and overall well‑being of our employees.
- Health Coverage: Subsidized medical, dental, and vision plans available after 28 days of employment.
- Retirement Savings: 401(k) plan with company matching contributions to help you build a robust financial future.
- Life & Disability Insurance: Protective coverage for you and your loved ones.
- Paid Time Off (PTO): Generous vacation, personal, and holiday leave to encourage work‑life balance.
- Wellness Resources: Access to on‑site cafeterias, fitness centers, and employee assistance programs.
- Professional Development: Tuition assistance, certification reimbursement, and internal training pathways.
- Recognition Programs: Service awards and performance incentives that celebrate dedication and excellence.
- Employee Discounts: Savings on movies, theme parks, zoos, and other entertainment options.
Career Growth & Learning Opportunities
At arenaflex, your career trajectory is shaped by ambition and continuous learning. As a Claims Customer Service Advocate II, you will have access to:
- Structured mentorship from seasoned claims and compliance experts.
- Cross‑training programs that expose you to other facets of the insurance value chain, such as underwriting, provider relations, and data analytics.
- Opportunities to obtain advanced certifications in claims processing, health‑care compliance, and project management.
- Potential pathways to supervisory or specialist roles within the Government Contracts division.
Work Environment & Culture at arenaflex
Our Myrtle Beach office is a modern, collaborative space designed to foster teamwork and innovation. Employees enjoy a blend of open‑plan workstations, quiet focus rooms, and communal areas that encourage informal networking. The culture at arenaflex is built on:
- Inclusivity: A commitment to diversity that celebrates varied perspectives and experiences.
- Integrity: Upholding the highest ethical standards in every interaction, especially when handling government contracts.
- Community Engagement: Active participation in local charitable initiatives and volunteer programs.
- Employee Empowerment: Platforms for voicing ideas, feedback, and suggestions that directly influence company practices.
Application Process & What to Expect Next
Ready to join a forward‑thinking team that values precision, service excellence, and personal growth? Follow these steps:
- Submit Your Application: Upload your resume and a concise cover letter highlighting how your experience aligns with the responsibilities and qualifications outlined above.
- Initial Review: Our recruiting specialists will assess your credentials for fit and may reach out for a brief telephone screening to verify key details and discuss salary expectations.
- Interview Phase: Qualified candidates will be invited to participate in one or more virtual or on‑site interviews with hiring managers and team members.
- Security Clearance: Successful candidates will begin the process of obtaining a C‑2 government clearance, a prerequisite for working on federal contracts.
- Offer & Onboarding: Upon clearance approval, you’ll receive a formal offer and begin a structured onboarding program that includes comprehensive training and mentorship.
Equal Opportunity & Accessibility Commitment
arenaflex is an equal‑opportunity employer. We celebrate diversity and are dedicated to creating an inclusive environment for all employees, regardless of age, race, color, national origin, gender, religion, veteran status, disability, sexual orientation, gender identity, or any other protected characteristic. As a federal contractor, we maintain robust affirmative‑action programs to ensure fair treatment for minorities, women, individuals with disabilities, and veterans.
If you require a reasonable accommodation during the application or interview process due to a disability, please contact us at mycareer.help@arenaflex.com or call 1‑800‑288‑2227, ext. 47480. We will evaluate your request on a case‑by‑case basis and provide appropriate support.
Join arenaflex Today!
Embark on a rewarding career where your dedication to accurate claims service makes a tangible difference for members, providers, and government partners alike. At arenaflex, you’ll be part of a legacy of excellence while shaping the future of health‑care administration. Apply now and become a vital member of our dynamic team!
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