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Provider Enrollment Quality Assurance Lead

2 months ago

Columbia, South Carolina, United States BlueCross BlueShield of South Carolina Full time

Provider Enrollment Quality Control and Training Lead

We are seeking a dedicated Provider Enrollment Quality Control and Training Lead at BlueCross BlueShield of South Carolina. In this pivotal role, you will be responsible for ensuring the integrity of provider information and developing analytical tools to keep leadership informed. Your responsibilities will include reviewing and rectifying data discrepancies, upholding quality assurance standards, and mentoring new team members. Additionally, you will act as a point of contact for complex issues, fostering a cooperative work atmosphere.

Key Responsibilities:

  • Conduct thorough evaluations of provider data to ensure accuracy and compliance.
  • Develop and implement reporting mechanisms to communicate findings to management.
  • Provide training and support to new analysts to enhance team capabilities.
  • Collaborate with various departments to resolve escalated data issues.

Qualifications:

  • A Bachelor’s degree or equivalent experience in a related field.
  • A minimum of two years of experience in provider network enrollment or certification.

What We Offer:

  • 401(k) retirement savings plan with company matching contributions.
  • Comprehensive health plans with subsidized options and complimentary vision coverage.
  • Life insurance coverage.
  • Generous paid time off and nine paid holidays each year.
  • Access to on-site cafeterias and fitness facilities.
  • Wellness initiatives and premium discounts.
  • Tuition reimbursement programs.
  • Recognition for years of service.