Analyst, Provider Enrollment

Palmetto GBA; Columbia (SC); On-site; USD 50,000 - 70,000; Full time

Job summary

A leading company in healthcare services is seeking an Analyst for Provider Enrollment. This full-time role involves evaluating applications, ensuring compliance, and providing excellent customer service. Candidates should possess relevant education and skills, with a preference for backgrounds in Business or Health Administration. The position offers comprehensive benefits and opportunities for professional growth.

Benefits

Health insurance

Dental insurance

Vision insurance

401k

Life insurance

Paid time off (PTO)

Discounts

Qualifications

• Degree in Business or Health Administration preferred.
• Knowledge of provider certification and Medicare regulations is beneficial.

Responsibilities

• Evaluate and process provider enrollment applications.
• Provide customer service and resolve discrepancies.
• Participate in process improvements and system testing.

Skills

Proficiency in MS Office

Good judgment

Communication

Organizational skills

Ability to handle sensitive information

Education

Bachelor's degree or 4 years related experience

Associate's degree with 2 years related experience

Tools

Microsoft Office

Job description

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Summary

Responsible for reviewing, researching, analyzing, and processing provider enrollment applications to ensure provider file integrity and compliance with established standards and guidelines.

Description

Logistics: Palmetto GBA – a subsidiary of BlueCross BlueShield of South Carolina.

Location: Full-time (40 hours/week), onsite at 17 Technology Circle, Columbia, SC, 29203. Work hours are 8:00AM-5:00PM, Monday-Friday, with occasional overtime as needed.

SCA Benefit Requirements: Employees cannot opt out of health benefits under the Service Contract Act. Supplemental pay is provided until health benefits are enrolled, 28 days post-hire.

What You'll Do

• Evaluate provider enrollment applications for acceptability, verify data authenticity, and set up EFT accounts.
• Enter and update provider data in the enrollment database and provider directories.
• Provide excellent customer service via correspondence and phone.
• Resolve discrepancies by obtaining information from internal departments, providers, and agencies.
• Distribute enrollment applications and information about the process.
• Participate in projects related to provider files and assist with system testing and process improvements.
• Support provider education and training initiatives.

Qualifications

• Education: Bachelor's degree or 4 years related experience, or Associate's degree with 2 years related experience.
• Skills: Proficiency in MS Office, good judgment, communication, organizational skills, and ability to handle sensitive information.
• Tools: Microsoft Office.

Preferred Qualifications

• Bachelor's in Business or Health Administration.
• Knowledge of provider certification, claims processing, Medicare regulations, and presentation skills.

Benefits

Eligible after 28 days, including health, dental, vision, 401k, life insurance, PTO, and discounts.

Next Steps

Application review, potential interview, and salary verification.

EEO Statement

We promote diversity and provide accommodations for disabilities and religious beliefs. For assistance, contact [e-mail] or call 800-288-2227, ext. 47480.

We participate in E-Verify and are an Equal Opportunity Employer.