Provider Enrollment Analyst
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About The Position
As a Provider Enrollment Analyst at BlueCross BlueShield of South Carolina, you will play a crucial role in the provider enrollment process. Your primary responsibilities will include reviewing, researching, analyzing, and processing provider enrollment applications to ensure compliance with established standards and guidelines. You will be responsible for maintaining the integrity of provider files and ensuring that all suppliers meet the necessary requirements. This position requires a keen eye for detail and the ability to work effectively with various stakeholders, including internal departments, providers, and government agencies. In this role, you may perform a variety of tasks related to the enrollment of providers. This includes determining the acceptability of provider enrollment applications, which may involve initial full applications, reenrollment, reactivation, or changes to existing information. You will conduct in-depth reviews and verifications of provider data, utilizing information databases and various organizations to ensure authenticity. Additionally, you will be responsible for setting up and testing Electronic Funds Transfer (EFT) accounts, processing and entering provider data into the appropriate enrollment database, and providing quality service to both external and internal customers. You will also be expected to communicate effectively with customers in response to inquiries, resolve discrepancies, and supply enrollment applications and general information about the enrollment process. Participation in special projects related to provider files and assisting technical support staff with system changes will also be part of your responsibilities. Furthermore, you will contribute to process improvements related to Provider Enrollment and assist with provider education and training. The work environment is typically an office setting, with the potential for remote opportunities for candidates with Medicare Administrator Contractor (MAC) Provider Enrollment experience. If you do not have MAC experience, the work location will be in Columbia, SC, with a standard schedule of Monday to Friday from 8 AM to 5 PM.
