Provider Data Specialist I (Onsite Columbia)

Southcarolinablues; Columbia, Northern (SC, KY); Hybrid; USD 38,000 - 52,000; Full time

Job summary

BlueCross BlueShield of South Carolina is seeking an on-site Provider File Specialist I in Columbia to manage and certify provider data, support claims adjudication, and ensure accurate provider directories. The role requires attention to detail, confidentiality, and effective communication within a healthcare network context.

You will work with PIMS and related systems, perform data updates, and contribute to quality improvement projects, with a typical 8:00 AM–5:00 PM schedule and some

Qualifications

• High School Diploma or equivalent required.
• 1 year of administrative/clerical support, customer service, claims processing, or provider network/certification experience preferred.
• Proficiency with word processing and spreadsheets; basic business math.

Responsibilities

• Verifies information and establishes certification of healthcare service providers.
• Maintains provider files/data on PIMS or provider systems.
• Identifies/assigns providers to networks/providers databanks.
• Contributes to production standards via PIMS/AMMS maintenance and reports.
• Participates in special projects (e.g., mass rate updates, audits, quality improvement).

Skills

Administrative support

Customer service

Communication

Discretion/Confidentiality

Education

High School Diploma

Tools

PIMS

Microsoft Office

Job description

BlueCross BlueShield of South Carolina is seeking an on-site Provider File Specialist I in Columbia to manage and certify provider data, support claims adjudication, and ensure accurate provider directories. The role requires attention to detail, confidentiality, and effective communication within a healthcare network context.

You will work with PIMS and related systems, perform data updates, and contribute to quality improvement projects, with a typical 8:00 AM–5:00 PM schedule and some