Onsite Provider File Specialist — Data & Certification

Southcarolinablues; Florence (SC); On-site; USD 36,000 - 48,000; Full time

Benefits offered by this job

401k with company match

Paid Time Off

Life Insurance

On-site amenities

Job summary

BlueCross BlueShield of South Carolina is seeking a Specialist, Provider File I-2. This on-site role in Florence, SC supports provider directories, claims adjudication, and provider billing by establishing and maintaining provider certifications and data in the provider information management system (PIMS).

You will verify information, update provider files, and collaborate on audits and special projects while maintaining confidentiality and delivering customer-focused service in a busy office

Qualifications

• High school diploma or equivalent required.
• 1 year of administrative/clerical support or related experience.
• Experience in customer service, claims processing or provider networks preferred.
• Basic math, discretion with confidential information, and good communication skills.

Responsibilities

• Verify information and establish certification of healthcare providers.
• Prepare and maintain provider files in the provider information management system (PIMS).
• Assign providers to the correct network and system.
• Support data maintenance and run reports in PIMS/AMMS as needed.
• Participate in projects such as rate updates and audits.

Skills

Word processing

Spreadsheet software

PIMS knowledge

Verbal and written communication

Discretion with confidential info

Basic math

Education

High School Diploma or equivalent

Tools

Microsoft Office

Job description

BlueCross BlueShield of South Carolina is seeking a Specialist, Provider File I-2. This on-site role in Florence, SC supports provider directories, claims adjudication, and provider billing by establishing and maintaining provider certifications and data in the provider information management system (PIMS).

You will verify information, update provider files, and collaborate on audits and special projects while maintaining confidentiality and delivering customer-focused service in a busy office