Sr. Provider Enrollment Analyst – Palmetto GBA

Job Description

Summary
 As a Sr. Provider Enrollment Analyst, you will act as a team lead by providing guidance, direction, and training to provider enrollment analysts and / or other provider enrollment area staff. You will also be responsible for the processing of difficult enrollment applications and / or complex inquiries.
Description
 

Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we have been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina and much more. We are one of the nation’s leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are committed to the same philosophy, consider joining our team!

Here is your opportunity to join a dynamic team at a diverse company with secure, community roots and an innovative future.

Logistics:

This position is onsite at 17 Technology Circle, Columbia, SC 29203. The hours are 8:00 a.m. – 5:00 p.m. Monday – Friday.

What You’ll Do:

• Function as team leader / senior-level enrollment analyst.
• Provide leadership, guidance, direction, and training to staff.
• Distribute work and is available to answer questions from staff.
• Act as a resource for staff regarding any escalating issues.
• Keep manager informed of any problems / issues that need resolving.
• Conduct quality reviews of completed work.
• Ensure that all audits are completed, verified, and closed.
• Perform analysis of audits to determine areas for training, development, and education.
• Ensure that quality work instructions, forms, and documents are developed and revised as needed.
• Provide quality service and communicates effectively with external / internal customers in response to inquiries (correspondence, telephone).
• Obtain information from internal departments, providers, government and / or private agencies, etc. to resolve discrepancies / problems.
• Interpret various guidelines and provides input to required procedures.
• Generate and analyze various provider reports to management.
• Participate in testing system changes related to provider files.
• Contribute, participate, and complete special projects as assigned.
• Typical office environment. May involve travel between office buildings.

To Qualify for This Position, You’ll Need:

• Bachelor’s degree OR four (4) years job related work experience OR Associate’s and two (2) years job-related work experience.
• Two (2) years of provider network enrollment / certification experience.
• 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.
• Experience with Microsoft Office.
• Experience with PECOS.
• Experience with MCS.

What We Prefer:

• Two (2) years of Provider Network Enrollment / Certification OR Medicare Part A/B experience.

What We can Do for You:

• 401(k) retirement savings plan with company match.
• Subsidized 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 major locations.
• Wellness programs and healthy lifestyle premium discount.
• Tuition assistance.
• Service recognition.
• Incentive Plan.
• Merit Plan.
• Continuing education funds for additional certifications and certification renewal.

What to Expect Next:

After submitting your application, our recruiting team members will review your resume to ensure your 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 be conducting interviews with the most qualified candidates, with prioritization give 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.