Sr Provider Enrollment Analyst

Summary
 Acts as a Team Lead by providing guidance/direction/training to Provider Enrollment Analysts and/or other Provider Enrollment area staff. Responsible for the processing of difficult enrollment applications and/or complex inquiries.
Description
 

Logistics: Palmetto GBA– one of BlueCross BlueShield's South Carolina subsidiary companies.

Location: This role is onsite at 17 Technology Circle Columbia, SC 29203
Work Environment: The work hours are Monday - Friday 8:00AM – 4:30PM.

What You'll Do:

• 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.

To Qualify for This Position, You'll Need:

• Required Education: Bachelor's

• Degree Equivalency: 4 years job related work experience or Associate's and 2 years job related work experience

• Required Work Experience: 2 years of provider network enrollment/certification experience.

• Required Software and tools: Microsoft Office

Required Skills and Abilities:

• 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.

We Prefer That You Have The Following:

• MAC & PECOS experience

Our comprehensive benefits package includes the following:

• 401(k) retirement savings plan with company match

• Fantastic 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 significant locations

• Wellness programs and a healthy lifestyle premium discount

• Tuition assistance

• Service Recognition

What We Can Do for You:

We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.

What to Expect Next:

After submitting your application, our recruiting team members will review your resume to ensure you 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 conduct interviews with those candidates who qualify, with prioritization given 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.