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Analyst, Provider Enrollment
2 months ago
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’ve been part of the national landscape, with our roots firmly embedded in the South Carolina community. Business and political climates may change, but we’re stronger than ever. Our A.M. Best rating is A+ (Superior) — making us the only health insurance company in South Carolina with that rating. We’re 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 dedicated to the same philosophy, consider joining our team
Notes:
SCA Eligible
Hours/Schedule: M-F, normal 8.5 hr. day (including lunch) start day as early as 7:00, but no later than 9:00.
Contract Only
Responsibilities:
Responsible in the provider enrollment process to review, research, analyze, and process provider enrollment applications.
Ensures provider file integrity and that suppliers are in compliance with established standards and guidelines.
65% 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.
20% 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.
10% 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.
5% Assists with provider education and provider services training.
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.
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.
Work Environment:
Typical office environment.
Required Education:
Bachelor's degree or 4 years of job related work experience, to include six months of experience working in an office environment.
Required Work Experience:
None Preferred Education: Bachelor's degree-in Business Administration or Health Administration.
This is the pay range that Magnit reasonably expects to pay someone for this position is
$15.00/hour - $17.20/hour . Benefits: Medical, Dental, Vision, 401K (provided minimum eligibility hours are met).
BlueCross is a strong supporter of our veterans, and many service men and women have joined our ranks. We’ve found the dedication, work ethic and job skills that serve well in the military excel in many of our lines of business, and we proudly have veterans filling positions in Human Resources, Information Technology, Customer Service, Operations, General Services and more.
Through our government contracts, we also have employees serving at Shaw Air Force Base, the Naval Health Clinic in Charleston, the Naval Hospital in Beaufort and in our hometown of Columbia, S.C., at Ft. Jackson. If you are a full-time employee in the National Guard or Reserves, we will even cover the difference in your pay if you are called to active duty. If you're ready to join in a diverse company with secure, community roots and an innovative future, apply for a position now
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