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Enrollment Quality Control and Training Specialist
2 months ago
About This Role
We are seeking a highly skilled and experienced professional to join our team as a Provider Enrollment Quality Assurance Lead at BlueCross BlueShield of South Carolina.
Key Responsibilities
- Review and analyze provider data to ensure accuracy and compliance with regulatory requirements.
- Develop and implement reporting tools to identify trends and issues, and provide recommendations for improvement.
- Collaborate with supervisors and other stakeholders to address individual errors and develop corrective action plans.
- Design and maintain departmental quality control protocols and policy and procedure manuals.
- Train new analysts on PIMS and departmental policies and procedures.
- Conduct training needs analysis based on quality control results and recommend training materials and subject matter.
- Serve as a resource to analysts with difficult or escalated issues.
- Work in a typical office environment with occasional travel between office buildings.
Requirements
- Bachelor's degree in any major or four years of job-related work experience.
- Two years of provider network enrollment/certification experience.
What We Offer
- Comprehensive benefits package, including 401(k) retirement savings plan, subsidized health plans, and life insurance.
- Opportunities for professional growth and development.
- A dynamic and supportive work environment.
