Lead, PE QC & Training

BlueCross BlueShield of South Carolina•Columbia, SC

35d•Onsite

About The Position

Senior level position focused on improving provider data quality by auditing the work of Provider Enrollment Analysts and Senior Provider Enrollment Analysts. Develops reports to keep management informed of the overall quality control of Provider Information Management Systems (PIMS). Performs training needs assessments and recommends training courses based on issues found during the quality control process. Provides training to new analysts and ongoing developmental training to the department. Description Logistics: BlueCross BlueShield of South Carolina - About Us | BlueCross BlueShield of South Carolina Location: This position is full-time (40-hours/week) Monday-Friday in a typical office environment. You will work an 8-hour shift scheduled during our normal business hours of 8:00AM-5:00PM. It may be necessary, given the business need to work occasional overtime. You may be required to travel between buildings. This role is located onsite at 17 Technology Circle, Columbia, SC, 29203.

Requirements

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.

Responsibilities

Reviews provider data to ensure accuracy.
Develops reporting tools to keep management abreast of any data error trends or issues.
Works with the supervisor to address individual errors.
Develops and maintains departmental quality control protocol and policy and procedure manuals ensuring any changes are properly communicated.
Trains new analysts on PIMS and departmental policies and procedures.
Conducts training needs analysis based on quality control results.
Recommends training materials and subject matter to management.
Serves as a resource to analysts with difficult or escalated issues.