Summary
 

As a Provider File Operations Supervisor, you will supervise provider enrollment and quality assurance staff.  You will ensure providers are loaded accurately and timely into system, appropriately assigned to networks, and updated correctly when necessary. You will also manage activities related to the provider file including file maintenance, quality assurance, credentialing, electronic funds transfer payment, provider directories, and applicable contract related requirements.

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:

• Oversee credentialing.
• Manage updates and maintenance of various other provider databases to ensure accurate reimbursement, network assignment, online and printed directories, and information for marketing disruption and member access studies also.
• Make recommendations and executes changes to meet work requirements.
• Develop, implement, and complete all inventory, production, error, and tracking reports.
• Supervise, motivate, train, and assist staff with questions.
• Responsible for recruiting and hiring, coaching and mentoring, monitoring and evaluation, and addressing all disciplinary issues in a timely manner.
• Encourage staff in creating and maintaining a work environment with high morale and employee satisfaction through support of professional development, training, career growth, and rewarding high performance.
• Research and respond to provider related inquiries from internal and external sources.
• Participate in system design, fulfillment of contract requirements, and in ongoing system testing.

To Qualify for This Position, You’ll Need:

• Bachelor's degree in a job-related field OR 4 years job related work experience OR Associate's and 2 years job related work experience.
• 3 years of provider network experience utilizing integrated computer systems.
• Excellent verbal and written communication skills.
• Excellent organizational, customer service, and presentation skills.
• Excellent analytical or critical thinking skills.
• Good judgment skills.
• Proficiency in spelling, grammar, and punctuation.
• Ability to persuade, negotiate, or influence others.
• Ability to handle confidential or sensitive information with discretion.
• Knowledge of provider credentialing process.
• Experience with Microsoft Office.
• Knowledge of computer systems support.

What We Prefer:

• Knowledge of mathematical or statistical concepts.
• Ability to use complex mathematical calculations.
• 3 years of MAC (Medicare Administrator Contractor) experience.
• Experience using Microsof