Provider Panel Architect

Blue Cross Blue Shield of Michigan; Lansing (MI); On-site; USD 45,000 - 65,000; Full time

Job summary

Blue Cross Blue Shield of Michigan is seeking a provider panels coordinator to build and maintain state-compliant provider panels. You will interface with agents, insureds, and internal teams to validate information and ensure timely postings.

Responsibilities include creating panels with Care Analytics, researching providers, and updating lists across states while staying current with regulations and licensure requirements.

Qualifications

• High school diploma or GED required; related coursework preferred.
• Minimum three years workers' compensation experience.
• Two years demonstrated technical knowledge in claims or medical environment.

Responsibilities

• Track production statistics and maintain databases for panels.
• Validate specialty, demographic info, and acceptance for injured workers.
• Respond to inquiries from agents, insureds and brands.
• Create provider panels using Care Analytics or other tools.
• Research using online mapping and search engines.
• Update provider lists for non-panel states.
• Ensure licensure and NPI accuracy for providers.
• Meet timelines for panel requests.

Skills

Medical provider specialties

Medical terminology

Regulations compliance

Contract interpretation

Research skills

Education

High school diploma or GED

Workers’ compensation/insurance coursework

Tools

Excel

Word

Windows

Job description

Blue Cross Blue Shield of Michigan is seeking a provider panels coordinator to build and maintain state-compliant provider panels. You will interface with agents, insureds, and internal teams to validate information and ensure timely postings.

Responsibilities include creating panels with Care Analytics, researching providers, and updating lists across states while staying current with regulations and licensure requirements.