Summary
 

As a Provider Enrollment Analyst, you will be responsible in the provider enrollment process to review, research, analyze, and process provider enrollment applications. You will also ensure provider file integrity and that suppliers are in compliance with established standards and guidelines.
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 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

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:

• 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.

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 expe