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BlueCross BlueShield of South Carolina · 1 day ago

Provider Enrollment Analyst

Duval County, FL

Full-time

Onsite

Mid, Senior Level

2+ years exp

BlueCross BlueShield of South Carolina is seeking a Provider Enrollment Analyst to manage the provider enrollment process. The role involves reviewing, researching, 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

Functions as Team Leader/senior-level Enrollment Analyst

Provides leadership/guidance/direction/training to staff

Distributes work and is available to answer questions from staff

Acts as a resource for staff regarding any escalating issues

Keeps manager informed of any problems/issues that need resolving

Conducts quality reviews of completed work

Ensures that all audits are completed, verified, and closed

Performs analysis of audits to determine areas for training, development, and education

Ensures that quality work instructions/forms/documents are developed/revised as needed

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

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

Interprets various guidelines and provides input to required procedures

Generates and analyzes various provider reports to management

Participates in testing system changes related to provider files

Contributes/participates/completes special projects as assigned

Qualification

Provider enrollment experienceClaims processing knowledgeMicrosoft OfficeAnalytical skillsCustomer service skillsBusiness math proficiencyJudgment skillsSpellingGrammarPricing methodology knowledgeMedicare regulations knowledgeOrganizational skillsPresentation skillsVerbal communicationWritten communicationConfidentiality handlingCritical thinking

Required

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

2 years of provider network enrollment/certification experience

Working knowledge of word processing, spreadsheet, and database software

Working knowledge of provider certification process and claims processing operations/systems

Good judgment skills required

Effective customer service, organizational, and presentation 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

In-depth knowledge of pricing methodology and discount programs

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

Microsoft Office

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