Summary
 

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.

Description
 

What You’ll Do:

• May perform any or all of the following in the enrollment of providers: determines the acceptability of provider enrollment applications (which may be used for initial full application, reenrollment, reactivation, change of information); provides in-depth review and verification/validation of provider data; verifies provider data by use of information databases and various organizations/agencies to ensure authenticity; sets up/tests EFT accounts.

• 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.

• Work environment: Typical office environment.

• This position can be located in Nashville, TN or Columbia, SC.

                      

To Qualify for This Position, You’ll Need:

• Bachelor's degree OR Four (4) years of job-related work experience, to include six (6) months of experience working in an office environment.

• Working knowledge of word processing, spreadsheet, and database software.

• Good judgment skills required.

• Effective customer service and organizational skills required.

• Demonstrated verbal and written communication skills.

• Demonstrated proficiency in spelling, punctuation, and grammar skills.

• Basic business math proficiency required.

• Analytical or critical thinking skills required.

• Ability to handle confidential or sensitive information with discretion.

• Microsoft Office.

We Prefer That You Have:

• Medicare Part A/B experience

What Blue Can Do For You:

Our comprehensive benefits package includes:

• 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

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