Provider Data & Certification Specialist

001 BlueCross and BlueShield of South Carolina; Florence (SC); On-site; USD 32,000 - 42,000; Full time

Benefits offered by this job

Subsidized health plans

Dental and vision coverage

401k retirement savings plan with firm

Life Insurance

Paid Time Off (PTO)

On-site cafeterias and fitness centers

Education Assistance

Service Recognition

National discounts

Job summary

BlueCross BlueShield of South Carolina is seeking an administrative professional to verify and certify healthcare providers, maintain provider data, and support network enrollment processes. The role requires strong Microsoft Office skills and the ability to handle confidential information with discretion.

You will work with provider management systems, assist with special projects, and contribute to timely claims adjudication and provider billing support.

Qualifications

• High School Diploma or equivalent required.
• 1 year of administrative/clerical support, customer service, claims processing, and/or provider network/certification experience.
• Working knowledge of word processing and spreadsheet software; ability to learn PIMS is a plus.
• Proficient in Microsoft Office; strong written and verbal communication; good organizational skills.

Responsibilities

• Verify information and establish certification of healthcare service providers.
• Prepare and maintain provider data in the provider information management system (PIMS).
• Assign providers to the appropriate network and provider system/database.
• Support department production standards via PIMS and AMMS maintenance and reports.
• Participate in special projects, such as mass rate updates or quality improvement audits.

Skills

Word processing

Spreadsheet

Customer service

Verbal/written communication

Basic business math

Confidential information handling

Education

High School Diploma or equivalent

Tools

Microsoft Office

Job description

BlueCross BlueShield of South Carolina is seeking an administrative professional to verify and certify healthcare providers, maintain provider data, and support network enrollment processes. The role requires strong Microsoft Office skills and the ability to handle confidential information with discretion.

You will work with provider management systems, assist with special projects, and contribute to timely claims adjudication and provider billing support.