Search the 74 jobs at BlueCross BlueShield of South Carolina

The Provider Enrollment Analyst is responsible for managing the provider enrollment process, reviewing and processing applications, ensuring data integrity, and assisting with provider education while collaborating with technical support and participating in special projects.

The Application Development Manager will oversee a team of developers and analysts, managing software modifications and enhancements for operational efficiency. They will coordinate project activities, ensure alignment with IT strategy, and support professional development among staff, while addressing technical issues and improving IT procedures.

As an Appeals Specialist, you will perform non-medical reviews and process redetermination letters, ensuring accuracy and timeliness. Your duties include preparing unit reports, analyzing workload, and utilizing various software tools to manage documentation and customer inquiries.

The Provider Enrollment Analyst is responsible for reviewing and processing provider enrollment applications, ensuring compliance with standards, maintaining provider file integrity, and communicating with internal and external customers. They assist in data entry, resolve issues, participate in special projects, and contribute to process improvements in Provider Enrollment.

The Quality Assurance Analyst II conducts quality control audits across various operations to ensure standards are followed, identifies weaknesses, provides training feedback, compiles performance data, and assists with special projects. The role focuses on analyzing processes, recommending improvements, and training new employees.

The Quality Assurance Analyst performs quality control audits and monitoring of departmental operations functions. The role involves identifying problems, analyzing causes and effects, making recommendations for improvements, and providing feedback to operations areas based on performance data. The analyst documents findings and assists in training and process documentation to enhance quality standards.

The Proposal Writer will handle the completion of all marketing RFPs/RFIs for large group marketing, maintaining proposal databases, collecting and analyzing market data, and providing detailed reports to management to enhance decision making and strategies.

The Enrollment Representative I is responsible for processing membership applications, updating enrollment files, resolving customer inquiries, and participating in special projects related to enrollment and billing. This role requires effective communication skills, analytical abilities, and knowledge of membership systems and documents.

As an Actuarial Assistant I, you will support actuarial services by conducting research, data analysis, and assisting in the preparation of actuarial models. You will also aid in profitability analyses and maintain financial reporting databases to support competitive pricing decisions for various lines of business.

The Operations Analyst will analyze proposed policies and procedures, recommend improvements, assist in implementing systems, conduct audits, generate reports, and maintain databases. The role requires effective communication and project management skills to evaluate processes and enhance operational efficiency.

The Partner Plan Manager ensures sales, retention, and service targets for Partner Plans are met. This role involves effective communication, monitoring marketplace trends, managing relationships, coordinating meetings, and completing reporting requirements.

As an Operations Analyst, you will analyze policies and procedures, recommend operational improvements, implement and maintain systems, and conduct audits. Additionally, you will generate reports and maintain databases, ensuring close communication with management on project statuses and trends.

The Provider Contracting Manager is responsible for establishing and maintaining provider networks, managing contract negotiations, ensuring compliance with contract obligations, and conducting financial analyses of contract proposals. This role requires effective relationship management with providers and coordination with internal departments to improve operational processes and training programs.

The Provider Enrollment Analyst is responsible for reviewing, researching, analyzing, and processing provider enrollment applications, ensuring compliance and integrity of provider data. Key tasks include data entry, providing customer service, resolving discrepancies, and supporting process improvements and special projects.

The Provider File Specialist I is responsible for maintaining healthcare provider files, ensuring accurate provider directories, claims adjudication, and billing processes. This role involves verifying information, preparing and managing provider data in relevant systems, and participating in special projects related to quality improvement and audits.

The Provider Enrollment Analyst is responsible for managing the provider enrollment process, which includes reviewing, analyzing, and processing applications, ensuring compliance, maintaining provider data integrity, and providing assistance with provider education and system changes.

The Operations Analyst will analyze policies, procedures, and reports to recommend operational improvements. They will evaluate existing processes, maintain documentation, conduct audits, generate reports, and serve as a liaison for various projects. The role emphasizes training staff and ensuring efficiency in operations while providing management with updates and insights based on data and metrics.

As a Provider Enrollment Analyst, you will review and process provider enrollment applications, ensuring data integrity and compliance with standards. You will also verify provider data, assist with special projects, and provide customer service related to the enrollment process.

Performs quality control audits across various operations functions to ensure quality standards are met. Develops and implements quality control programs and provides feedback on errors detected. Assists with special projects and training new employees.

The Sr. Provider Relations Representative is responsible for educating and training network providers and other stakeholders, developing training materials, facilitating meetings and workshops, and ensuring that educational needs are met. This role also involves administrative support and generating reports for management as needed.