Provider Data & Certification Specialist I

001 BlueCross and BlueShield of South Carolina; Myrtle Beach (SC); On-site; USD 42,000 - 55,000; Full time

Benefits offered by this job

Subsidized health plans

Dental and vision coverage

401k retirement savings plan with公司匹配

Life Insurance

Paid Time Off

On-site cafeterias and fitness centers

Job summary

BlueCross BlueShield of South Carolina is seeking a Provider File Specialist I to establish and maintain provider files to support directories, claims adjudication, and provider billing.

The role requires a high school diploma or equivalent, with about one year of administrative support and customer service experience. Proficiency in MS Office and a willingness to learn PIMS are important. Office-based, full-time position located in Myrtle Beach, SC.

Qualifications

• High School Diploma or equivalent.
• 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.

Responsibilities

• Verifies necessary information and establishes certification of healthcare service providers.
• Prepares and maintains provider data in PIMS or provider systems/databases.
• Identifies providers and assigns them to the appropriate network/system.
• Maintains data and runs reports in PIMS/AMMS or provider systems.
• Contributes to special projects such as audits and quality improvement.

Skills

Administrative support

Customer service

Data entry

Office software

Education

High School Diploma or equivalent

Tools

PIMS

Microsoft Office

Job description

BlueCross BlueShield of South Carolina is seeking a Provider File Specialist I to establish and maintain provider files to support directories, claims adjudication, and provider billing.

The role requires a high school diploma or equivalent, with about one year of administrative support and customer service experience. Proficiency in MS Office and a willingness to learn PIMS are important. Office-based, full-time position located in Myrtle Beach, SC.