Analyst, Provider Enrollment

Palmetto GBA•Columbia, SC

1d•Onsite

About The Position

The Analyst, Provider Enrollment reviews, researches, analyzes, and processes provider enrollment applications, ensuring provider file integrity and compliance with established standards and guidelines. The role is onsite at Palmetto GBA, a BlueCross BlueShield of South Carolina subsidiary, at 17 Technology Circle, Columbia, South Carolina. This is a full-time, 40-hour-per-week position scheduled Monday through Friday for an eight-hour shift during normal business hours of 8:00 a.m. to 5:00 p.m. Occasional overtime may be necessary, and travel between buildings may be required. The position is not eligible for sponsorship now or in the future. The role is subject to Service Contract Act requirements. Employees must enroll in the company's health insurance, even if they have other coverage. Supplemental pay for health coverage is provided until enrollment is complete; coverage begins on the first day of the month following 28 days of full-time employment.

Requirements

Bachelor's degree equivalency: four years of job-related work experience, or an associate's degree and two years of job-related work experience.
Working knowledge of word processing, spreadsheet, and database software.
Good judgment skills.
Effective customer service and organizational skills.
Demonstrated verbal and written communication skills.
Demonstrated proficiency in spelling, punctuation, and grammar.
Basic business math proficiency.
Analytical or critical thinking skills.
Ability to handle confidential or sensitive information with discretion.
Proficiency with Microsoft Office.

Nice To Haves

Bachelor's degree in business administration or health administration.
In-depth knowledge of the provider certification process, claims processing operations and systems, and pricing methodology and discount programs.
In-depth knowledge of Medicare program instructions and regulations related to provider enrollment and issues.
Effective presentation skills.
Eight years of MAC PE experience.

Responsibilities

Determine the acceptability of provider enrollment applications for initial enrollment, reenrollment, reactivation, or changes of information.
Review and verify or validate provider data in depth.
Use information databases and various organizations or agencies to verify provider data and ensure its authenticity.
Set up and test electronic funds transfer (EFT) accounts.
Enter and update provider data and applications in the appropriate enrollment database used to evaluate and track application processing or update provider directories.
Provide quality service and communicate effectively with internal and external customers in response to correspondence and telephone inquiries.
Obtain information from internal departments, providers, government agencies, and private agencies to resolve discrepancies or problems.
Provide enrollment applications and general information about the enrollment process to interested enrollees.
Contribute to and participate in 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.

Benefits

Subsidized health plans
Dental coverage
Vision coverage
401(k) 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
Supplemental pay for health coverage until health insurance enrollment is complete