Summary
 

As a Sr. Provider Enrollment Analyst, you will act as a team lead by providing guidance, direction, and training to provider enrollment analysts and / or other provider enrollment area staff.  You will also be responsible for the processing of difficult enrollment applications and / or complex inquiries.

Description
 

Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we have been part of the national landscape, 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 that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are committed to the same philosophy, consider joining our team!

Here is your opportunity to join a dynamic team at a diverse company with secure, community roots and an innovative future.

Logistics:

This position is onsite at 17 Technology Circle, Columbia, SC 29203. The hours are 8:00 a.m. – 5:00 p.m. Monday – Friday.

What You’ll Do:

• Function as team leader / senior-level enrollment analyst.
• Provide leadership, guidance, direction, and training to staff.
• Distribute work and is available to answer questions from staff.
• Act as a resource for staff regarding any escalating issues.
• Keep manager informed of any problems / issues that need resolving.
• Conduct quality reviews of completed work.
• Ensure that all audits are completed, verified, and closed.
• Perform analysis of audits to determine areas for training, development, and education.
• Ensure that quality work instructions, forms, and documents are developed and revised as needed.
• Provide quality service and communicates effectively with external / internal customers in response to inquiries (correspondence, telephone).
• Obtain information from internal departments, providers, government and / or private agencies, etc. to resolve discrepancies / problems.
• Interpret various guidelines and provides input to required procedures.
• Generate and analyze various provider reports to management.
• Participate in testing system changes related to provider files.
• Contribute, participate, and complete special projects as assigned.
• Typical office environment. May involve travel between office buildings.

    

To Qualify for This Position, You’ll Need:

• Bachelor's degree OR four (4) years job related work experience OR Associate's and two (2) years job-related work experience.
• Two (2) years of provider network enrollment / certification experience.
• Working knowledge of word processing, spreadsheet, and database software.
• Working knowledge of provider certification process and claims processing operations / systems.
• Good judgment skills required.
• Effective customer service, organizational, and presentation 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.
• In-depth knowledge of pricing methodology and discount programs.
• In-depth knowledge of Medicare p