The Total Water Level and Coastal Change Forecast (TWL&CC Forecast) provides coastal communities with 6-day notice of potential elevated water levels and coastal change (i.e., dune erosion, overwash, or inundation) on sandy beaches that threatens safety, infrastructure, or resources. This continuously operating model provides hourly information for select regions along U.S. Gulf of Mexico and Atlantic Ocean coastlines. The objective of this work is to assess the skill of forecasts during a period of elevated water levels along the coasts of North Carolina (NC) and South Carolina, USA caused by Hurricane Isaias in August 2020, using a combination of observations and model hindcasts. Water levels and waves were observed throughout the storm at three locations near Wrightsville Beach, NC, which provided information to assess forecast skill; a wave buoy offshore, a tide gage at a local pier, and a pressure sensor deployed at the pier. In addition to observations, the non-hydrostatic phase-resolving model SWASH (Simulating WAves till SHore) was forced with hourly wave energy spectra derived from a coupled Delft3D-SWAN simulation during the peak of Isaias, to complement observations by computing nearshore wave height and wave-induced setup and runup at the shoreline. During the storm peak, SWASH-simulated water levels at the sensor position were comparable to those at the maximum landward extent (bias=-0.05m; gain=0.26; r2=0.99), suggesting that observations at the USGS sensor location were a useful proxy for total water level (TWL; sum of tide, surge and wave runup) at the shoreline that are predicted by the TWL&CC Forecast. The TWL forecast at Wrightsville Beach was consistent with observations from the USGS sensor (bias=-0.38m and -0.74m, scatter index=0.22 and 0.28 for the two forecast model grids considered, respectively; weighted regression considering model uncertainty explained 95 percent of variability in observed TWL). Observed TWL was within the confidence interval of the TWL&CC Forecast for the five hours at the storm peak. Forecast mean water levels (MWL; sum of tide, surge and wave setup) and tide gage observations were also consistent (bias=0.07m and 0.02m for the forecast model grids; scatter index=0.46; r2=0.80). Forecast MWL at the storm peak was within 0.06m of the observed MWL from the tide gage for both sites. In the region where Isaias made landfall, eight additional pressure sensors were compared to the peak TWL forecast (bias=0.14m; scatter index=0.18). Forecast TWL explained 90 percent of observed variability in TWL when considering uncertainty of the forecast with a weighted regression. The results demonstrate that wave-driven water levels contributed a significant portion of the forecast TWL during Isaias (52 percent during the three peak hours of the storm), and that TWL were represented using the forecast model. Mean absolute error of the coastal change forecast and observed overwash is 0.4 and 0.14 for the two forecast model grids considered. The skill demonstrated by this computationally efficient method indicates that the forecasting system can provide fast and reliable predictions of TWL across hundreds of km of coastline at sub-km resolution, days to hours in advance of when storms threaten coastal regions.