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Provider Enrollment Analyst

External
ourhrconnect logoOurhrconnect · Columbia, SC
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Compliance
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About the role

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. Logistics: Palmetto GBA - one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This position is full-time (40-hours/week) Monday-Friday in a typical office environment. You will work an 8-hour shift scheduled during our normal business hours of 8:00AM-5:00PM. It may be necessary, given the business need to work occasional overtime. You may be required to travel between buildings. This role is located onsite at 17 Technology Circle, Columbia, SC, 29203. Government Clearance: This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen. SCA Benefit Requirements: BlueCross BlueShield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act (SCA). As a Service Contract Act (SCA) employee, you are required to enroll in our health insurance, even if you already have other health insurance. Until your enrollment is complete, you will receive supplemental pay for health coverage. Your coverage begins on the first day of the month following 28 days of full-time employment.

Responsibilities

  • 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.
  • 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.
  • 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.
  • Assists with provider education and provider services training.
  • To Qualify for This Position, You'll Need the Following:
  • Required Education: Bachelor's degree equivalency: Four (4) years job-related work experience or associate's and two (2) years job related work experience.
  • Required Software and Tools: Microsoft Office.
  • We Prefer That You Have the Following:
  • Preferred Education: Bachelor's degree in business administration or health administration.
  • Our Comprehensive Benefits Package Includes the Following:
  • We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment.
  • Subsidized health plans, dental and vision coverage
  • 401k retirement savings plan with company match
  • Life Insurance
  • Paid Time Off (PTO)
  • On-site cafeterias and fitness centers in major locations
  • Education Assistance
  • Service Recognition
  • National discounts to movies, theaters, zoos, theme parks and more
  • What We Can Do for You:
  • We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.
  • What To Expect Next:
  • After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salar

Benefits

Health insuranceDental insuranceVision insurance401(k)Paid time off

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