Provider Data & Systems Specialist

001 BlueCross and BlueShield of South Carolina; Columbia (SC); In loco; USD 42.000 - 56.000; Tempo pieno

Vantaggi offerti da questo lavoro

Subsidized health plans

401k retirement savings plan with 회사 매

Life Insurance

Paid Time Off (PTO)

On-site cafeterias and fitness centers

Education Assistance

Service Recognition

National discounts

Descrizione del lavoro

BlueCross BlueShield of South Carolina is seeking a detail-oriented provider data coordinator to manage provider files, enrollments, and certifications across our provider systems. You will run queries and generate reports for leadership, supporting enterprise and departmental insights.

The role requires strong communication abilities, proficiency with Microsoft Office, and knowledge of PIMS/AMMS. It is an on-site position located in Columbia, SC, with regular daytime hours and some travel

Competenze

• 3 years of experience in customer service, claims processing, and/or provider network certification, or combination
• Working knowledge of PIMS and AMMS
• Knowledge of pricing methodology and discount programs
• Good judgment, verbal and written communication skills
• Basic business math and analytical thinking

Mansioni

• Obtain information and certify healthcare service providers.
• Maintain provider data in provider information management system (PIMS) or related systems.
• Generate and analyze provider reports for management.
• Provide technical support through system testing and enhancements.
• Research and resolve provider issues related to eligibility, recertifications, edits, billing, etc.
• Contribute to production standards on PIMS/AMMS or related systems.
• Participate in special projects such as mass rate updates, quality improvement, audits.

Conoscenze

Communication skills

Analytical thinking

Discretion

Formazione

High School Diploma or equivalent

Strumenti

Microsoft Office

DB2

Descrizione del lavoro

BlueCross BlueShield of South Carolina is seeking a detail-oriented provider data coordinator to manage provider files, enrollments, and certifications across our provider systems. You will run queries and generate reports for leadership, supporting enterprise and departmental insights.

The role requires strong communication abilities, proficiency with Microsoft Office, and knowledge of PIMS/AMMS. It is an on-site position located in Columbia, SC, with regular daytime hours and some travel