Senior Provider Enrollment Analyst - Palmetto GBA

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 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 program instructions/regulations related to provider enrollment/issues.
• Required Software and Tools: Microsoft Office.

We Prefer That You Have the Following:

• Preferred Skills and Abilities: Medicare Part A experience.

What We Can Do for You:

We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.

Our comprehensive benefits package includes the following:

We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment.

• Subsidized health plans, dental and vision coverage.

• 401k retirement savings plan with company match.

• Life Insurance.

• Paid Time Off (PTO).

• On-site cafeterias and fitness centers in major locations.

• Education Assistance.

• Service Recognition.

• National discounts to movies, theaters, zoos, theme parks and more.

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 specifics and salary requirements.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.

Some states have required notifications. Here's more information. 

Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains Affirmative Action programs to promote employment opportunities for minorities, females, disabled individuals and veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities.

If you need special assistance or an accommodation while seeking employment, please e-mail mycareer.help@bcbssc.com or call 1-800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.