Apply on Employer Site

BlueCross BlueShield of South Carolina · 1 day ago

Provider Enrollment Analyst

Columbia, SC

Full-time

Onsite

Entry, Mid Level

2+ years exp

BlueCross BlueShield of South Carolina is a healthcare organization focused on provider enrollment processes. The Provider Enrollment Analyst is responsible for reviewing, analyzing, and processing provider enrollment applications while ensuring compliance with established standards and guidelines.

Financial ServicesHealth CareHealth InsuranceInsuranceMedical

No H1B

Security Clearance Required

U.S. Citizen Only

Responsibilities

May perform any or all of the following in the enrollment of providers: determines the acceptability of provider enrollment applications (which may be used for initial full application, reenrollment, reactivation, change of information); provides in-depth review and verification/validation of provider data; verifies provider data by use of information databases and various organizations/agencies to ensure authenticity; sets up/tests EFT accounts

Processes/enters/updates provider data information/applications into appropriate enrollment database used in evaluating/tracking the processing of the application and/or updating of provider directories

Provides quality service and communicates effectively with external/internal customers in response to inquiries (correspondence, telephone)

Obtains information from internal department, providers, government and/or private agencies, etc. to resolve discrepancies/problems

Supplies enrollment applications and general information on the enrollment process to interested enrollees

Contributes to and participates on special projects related to provider files

Assists technical support staff with testing system changes related to provider files

Assists with process improvements related to Provider Enrollment

Assists with provider education and provider services training

Qualification

Provider enrollment processDatabase softwareMicrosoft OfficeCustomer serviceAnalytical skillsJudgment skillsBusiness math proficiencyEffective communicationOrganizational skillsConfidentiality

Required

Bachelor's degree equivalency: Four (4) years job-related work experience or associate's and two (2) years job related work experience

Working knowledge of word processing, spreadsheet, and database software

Good judgment skills required

Effective customer service and organizational skills required

Demonstrated verbal and written communication skills

Demonstrated proficiency in spelling, punctuation, and grammar skills

Basic business math proficiency required

Analytical or critical thinking skills required

Ability to handle confidential or sensitive information with discretion

Microsoft Office

Preferred

Bachelor's degree in business administration or health administration

In-depth knowledge of provider certification process, claims processing operations/systems, and pricing methodology and discount programs

In-depth knowledge of Medicare program instructions/regulations related to provider enrollment/issues

Effective presentation skills

Benefits

Subsidized health plans, dental and vision coverage

401k retirement savings plan with company match

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

Company

BlueCross BlueShield of South Carolina

Glassdoor3.6

For more than six decades, BlueCross BlueShield of South Carolina has been part of the national landscape. Our roots are firmly embedded in the state.

Founded in 1946

Columbia, South Carolina, USA

10001+ employees