Provider File Specialist I

External

Ourhrconnect · Columbia, SC

Full-timeOn-siteToday

AuditingSQL

Cover Letter Connect

Prepare for this interview

Elite

AI-generated questions, company research, and talking points tailored to this role

About the role

Responsible for establishing and maintaining certification and/or preparation, review and/or maintenance of healthcare provider files in support of provider directories, accurate/timely claims adjudication, and provider billing. Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are 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, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! Logistics: BlueCross BlueShield of South Carolina - About Us | BlueCross BlueShield of South Carolina 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 8:00 AM-5:00 PM. 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.

Responsibilities

Identifies/assigns providers to the appropriate network and provider system/database.

Contributes to department's production standard by working on PIMS and AMMS (automated medical management systems) or appropriate provider system/database maintenance/error reports.

Contributes to and participates on special projects, which may include but are not limited to the following: mass rate updates, quality improvement, audits, etc.

To Qualify for This Position, You'll Need the Following:

Required Education: High School Diploma or equivalent

Degree Equivalency:

Required Experience: 1 year of administrative/clerical support, customer service, claims processing, and/or provider network/certification experience.

Required Software and Other Tools: Microsoft Office

We Prefer That You Have the Following:

Preferred Skills and Abilities: Ability to learn DB2, SQL language to create/run PIMS queries for QC/research purposes.

Demonstrates strong telephone customer service skills.

Quality and auditing experience.

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 salary requirements.

Equal Employment Opportunity Statement

Provider File Specialist I

About the role

Responsibilities

Benefits

Your Match

Company Intel

What employees say

Interested in this role?