Analyst, Sr Provider Enrollment

Posted 7 Days Ago
Be an Early Applicant
Columbia, SC
Mid level
Insurance
The Role
The Sr. Provider Enrollment Analyst will lead the team in guiding staff, processing difficult enrollment applications, conducting quality reviews, ensuring audits are completed, and participating in special projects while providing effective communication to internal and external stakeholders.
Summary Generated by Built In


Summary
 
As a Sr. Provider Enrollment Analyst, you will act as a team lead by providing guidance/direction/training to Provider Enrollment Analysts and/or other provider enrollment area staff. You will also be responsible for the processing of difficult enrollment applications and/or complex inquiries.
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:

  • Function as team leader/senior-level enrollment analyst.
  • Provide leadership/guidance/direction/training to staff.
  • Distribute work and is available to answer questions from staff.
  • Act as a resource for staff regarding any escalating issues.
  • Keep manager informed of any problems/issues that need resolving.
  • Conduct quality reviews of completed work.
  • Ensure that all audits are completed, verified, and closed.
  • Perform analysis of audits to determine areas for training, development, and education.
  • Ensure that quality work instructions/forms/documents are developed/revised as needed.
  • Provide quality service and communicates effectively with external/internal customers in response to inquiries (correspondence, telephone).
  • Obtain information from internal departments, providers, government and/or private agencies, etc. to resolve discrepancies/problems.
  • Interpret various guidelines and provides input to required procedures.
  • Generate and analyze various provider reports to management.
  • Participate in testing system changes related to provider files.
  • Contributes/participates/completes special projects as assigned.

To Qualify for This Position, You'll Need:

  • Bachelor's Degree OR 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.
  • Experience with Microsoft Office.


Work Environment:

  • Typical office environment.
  • Work may involve some travel between office buildings and some out-of-town travel.

What We can Do for You:

  • 401(k) retirement savings plan with company match.
  • Subsidized health plans and free vision coverage.
  • Life insurance.
  • Paid annual leave – the longer you work here, the more you earn.
  • Nine paid holidays.
  • On-site cafeterias and fitness centers in major locations.
  • Wellness programs and healthy lifestyle premium discount.
  • Tuition assistance.
  • Service recognition.
  • Incentive Plan.
  • Merit Plan.
  • Continuing education funds for additional certifications and certification renewal.

What to Expect Next:

After submitting your application, our recruiting team members will review your resume to ensure your meet the qualifications.  This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.

Management will be conducting interviews with the most qualified candidates, with prioritization give to those candidates who demonstrate the preferred qualifications.


 

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 [email protected] 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.

Top Skills

MS Office
The Company
HQ: Columbia, SC
10,001 Employees
On-site Workplace
Year Founded: 1946

What We Do

For more than six decades, BlueCross BlueShield of South Carolina has been part of the national landscape. Our roots are firmly embedded in the state. We are the largest insurance company in South Carolina. We are also the only one that has an A+ Superior A.M. Best rating. We are one of the nation's leading government contract administrators. We operate one of the most sophisticated data processing centers in the Southeast and have a diverse family of subsidiary companies.

Our full-time employees enjoy benefits like a 401(k) retirement savings plan with company match, subsidized health plans, free vision coverage, life insurance, paid annual leave and holidays, wellness programs and education assistance. If you are a full-time employee in the National Guard or reserves, we will cover the difference in your pay if you are called to active duty. BlueCross has a dedicated corporate culture of community support. Our employees are some of the most giving in the country. They support dozens of nonprofit organizations every year.

If you're ready to join a diverse company with secure, community roots and an innovative future, apply for a position now!

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