Provider Enrollment Analyst - Palmetto GBA

BlueCross BlueShield of South Carolina•Columbia, SC

7d•Onsite

About The Position

Logistics: Palmetto GBA – one of BlueCross BlueShield's South Carolina subsidiary companies. 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 SCA Benefit Requirements: BlueCross BlueShield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act (SCA). Under the McNamara-O'Hara Service Contract Act (SCA), employees cannot opt out of health benefits. Employees will receive supplemental pay until they are enrolled in health benefits 28 days after the hire date.

Requirements

Required Education: Bachelor’s degree equivalency: Four (4) years job-related work experience or associate's and two (2) years job related work experience.
Required Skills and Abilities: 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.
Required Software and Tools: Microsoft Office.

Nice To Haves

Preferred Education: Bachelor's degree-in Business Administration or Health Administration.
Preferred Skills and Abilities: 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. Effective presentation skills.

Responsibilities

May perform any or all of the following in the enrollment of providers: determines the acceptability of provider enrollment applications (which may be used for initial full application, reenrollment, reactivation, change of information)
provides in-depth review and verification/validation of provider data
verifies provider data by use of information databases and various organizations/agencies to ensure authenticity
sets up/tests EFT accounts.
Processes/enters/updates provider data information/applications into appropriate enrollment database used in evaluating/tracking the processing of the application and/or updating of provider directories.
Provides quality service and communicates effectively with external/internal customers in response to inquiries (correspondence, telephone).
Obtains information from internal department, providers, government and/or private agencies, etc. to resolve discrepancies/problems.
Supplies enrollment applications and general information on the enrollment process to interested enrollees.
Contributes to and participates on special projects related to provider files.
Assists technical support staff with testing system changes related to provider files.
Assists with process improvements related to Provider Enrollment.
Assists with provider education and provider services training.

Benefits

We offer our employees great benefits and rewards.
You will be eligible to participate in the benefits the first of the month following 28 days of employment.
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