Central Supervision Analyst
TD
Senior Provider Enrollment Analyst
BlueCross BlueShield of South Carolina
full-time
Posted on:
Location Type: Hybrid
Location: Columbia • South Carolina • 🇺🇸 United States
Visit company websiteJob Level
Senior
About the role
- Acts as a Team Lead by providing guidance/direction/training to Provider Enrollment Analysts and/or other Provider Enrollment area staff
- Responsible for the processing of difficult enrollment applications and/or complex inquiries
- 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
Requirements
- Bachelor’s degree equivalency: 4 years job-related work experience or associate's and 2 years job related work experience
- 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 program instructions/regulations related to provider enrollment/issues
- Microsoft Office proficiency
Benefits
- 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
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
provider network enrollmentprovider certificationclaims processingauditingdata analysisbusiness mathquality reviewreport generationsystem testingdocumentation development
Soft skills
leadershipcustomer serviceorganizational skillspresentation skillsverbal communicationwritten communicationanalytical thinkingcritical thinkingjudgmentdiscretion
