Provider Enrollment Analyst (Palmetto GBA)

Summary
 As a Provider Enrollment Analyst, you will be responsible in the provider enrollment process to review, research, analyze, and process provider enrollment applications. You will also ensure provider file integrity and that suppliers are in compliance with established standards and guidelines.
Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we have been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina and much more. We are one of the nation’s leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are committed to the same philosophy, consider joining our team!
Here is your opportunity to join a dynamic team at a diverse company with secure, community roots and an innovative future.
Description
 

Logistics: This position is onsite at 17 Technology Circle, Columbia, SC 29203. The hours are 8:00 a.m. – 5:00 p.m. Monday – Friday.

What You’ll Do:

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

• Process, enter, and update provider data information / applications into appropriate enrollment database used in evaluating and tracking the processing of the application and / or updating of provider directories.

• Provide quality service and communicate effectively with external and internal customers in response to inquiries (correspondence, telephone).

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

• Supply enrollment applications and general information on the enrollment process to interested enrollees.

• Contribute to and participates on special projects related to provider files.

• Assist technical support staff with testing system changes related to provider files.

• Assist with process improvements related to provider enrollment.

• Assist with provider education and provider services training.

To Qualify for This Position, You’ll Need:

• Bachelor's degree OR Four (4) years of job-related work experience OR associate’s degree and Two (2) years of 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.

• Experience with Microsoft Office.

What We Prefer:

• Medicare experience in Part A and / or Part B Provider Enrollment or credentialing experience.

• 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.

• MAC (Medicare Administrator Contractor) provider enrollment experience.

• Effective presentation skills.

What We can Do for You:

• 401(k) retirement savings plan with company match.

• Subsidized health plans and free vision coverage.

• Life insurance.

• Paid annual leave – the longer you work here, the more you earn.

• Nine paid holidays.

• On-site cafeterias and fitness centers in major locations.

• Wellness programs and healthy lifestyle premium discount.

• Tuition assistance.

• Service recognition.

• Incentive Plan.

• Merit Plan.

• Continuing education funds for additional certifications and certification renewal.

What to Expect Next:

After submitting your application, our recruiting team members will review your resume to ensure your 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 be conducting interviews with the most qualified candidates, with prioritization give to those candidates who demonstrate the preferred qualifications.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.

Some states have required notifications. Here's more information. 

Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina 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. Additionally, as a federal contractor, the company maintains Affirmative Action programs to promote employment opportunities for minorities, females, disabled individuals and veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are 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 e-mail [email protected] or call 1-800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.