Summary
 

As a Sr. Provider Enrollment Analyst, you will act as a team lead by providing guidance/direction/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.

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!

Description
 

Logistics: Palmetto GBA – one of BlueCross BlueShield's South Carolina subsidiary companies.

Location: This is a full-time (40-hours/week) Monday-Friday Work at Home position. 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.

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). Under the McNamara-O'Hara Service Contract Act (SCA), employees cannot opt out of health benefits. Employees will receive supplemental pay until they are enrolled in health benefits 28 days after the hire date.

What You'll Do:

• Functions as team leader/senior-level enrollment Analyst.
• Provides leadership/guidance/direction/training to staff.
• Distributes work and is available to answer questions from staff.
• Acts as a resource for staff regarding any escalating issues.
• Keeps manager informed of any problems/issues that need resolving.
• Conducts quality reviews of completed work.
• Ensures that all audits are completed, verified, and closed.
• Performs analysis of audits to determine areas for training, development, and education.
• Ensures that quality work instructions/forms/documents are developed/revised as needed.
• Provides quality service and communicates effectively with external/internal customers in response to inquiries (correspondence, telephone).
• Obtains information from internal departments, providers, government and/or private agencies, etc. to resolve discrepancies/problems.
• Interprets various guidelines and provides input to required procedures.
• Generates and analyzes various provider reports to management.
• Participates in testing system changes related to provider files.
• Contributes/participates/completes special projects as assigned.

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

• Required Education: Bachelor's degree equivalency: 4 years job related work experience or Associate's and 2 years job related work experience.
• Required Work Experience: 2 years of provider network enrollment/certification experience.
• Required Skills and Abilities: Working knowledge of word processing, spreadsheet, and database software. Working knowledge of provid