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Provider Enrollment Quality Assurance Lead
2 months ago
About This Role
BlueCross BlueShield of South Carolina is seeking a highly skilled Provider Enrollment Quality Assurance Lead to join our team. As a key member of our organization, you will play a critical role in ensuring the accuracy and quality of provider data.
Key Responsibilities
- Review and analyze provider data to identify errors and discrepancies.
- Develop and implement reporting tools to track data trends and issues.
- Collaborate with supervisors to address individual errors and implement corrective actions.
- Develop and maintain quality control protocols and policy manuals to ensure compliance and consistency.
- Train new analysts on PIMS and departmental policies and procedures.
- Conduct training needs analysis based on quality control results.
- Recommend training materials and subject matter to management.
- Serve as a resource to analysts with complex or escalated issues.
Work Environment
This is a typical office environment with occasional travel between office buildings. The ideal candidate will have excellent communication and analytical skills, with the ability to work independently and as part of a team.
Requirements
- Bachelor's degree in any major or four years of job-related work experience.
- Two years of provider network enrollment/certification experience (can be concurrent).
What We Offer
BlueCross BlueShield of South Carolina offers a comprehensive benefits package, including:
- 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 a healthy lifestyle premium discount.
- Tuition assistance.
- Service recognition.
