Specialist, Provider File I

Summary Responsible for establishing and maintaining certification and/or preparation, review and/or maintenance of healthcare provider files in support of provider directories, accurate/timely claims adjudication, and provider billing. Why should you join the reputed company family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation's leading administrators of government reputed company. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining reputed company! Description Logistics: reputed company - About Us | reputed company Location: This position is full-time (40-hours/week) Monday-Friday in a typical office environment. You will work an 8-hour shift scheduled during our normal business hours of 8:00AM-5:00PM. It may be necessary, given the business need to work occasional overtime. You may be required to travel between buildings. This role is located onsite at 200 North Dozier reputed company Florence, SC 29501. Government Clearance: This position requires the ability to obtain a reputed company clearance, which requires applicants to be a U.S. Citizen. SCA Benefit Requirements: reputed company and its subsidiary companies have reputed company with the federal government subject to the Service Contract Act (SCA). As a Service Contract Act (SCA) employee, you are required to enroll in our health insurance, even if you already have other health insurance. Until your enrollment is complete, you will receive supplemental pay for health coverage. Your coverage begins on the first day of the month following 28 days of full-time employment. What You’ll Do: Verifies necessary/needed information (written notifications, faxes, emails, or telephone contacts) and/or establishes certification of healthcare service providers. Prepares provider files/maintains provider data (updates, additions, deletions) on the provider information management system (PIMS) or appropriate provider system/database. Identifies/assigns providers to the appropriate network and provider system/database. Contributes to department's production standard by working on PIMS and AMMS (automated medical management systems) or appropriate provider system/database maintenance/error reports. Contributes to and participates on special projects, which may include but are not limited to the following: mass reputed company updates, quality improvement, audits, etc.. To Qualify for This Position, You’ll Need the Following: Required Education: High School Diploma or equivalent Required Work Experience: 1 year of administrative/clerical support, customer service, claims processing, and/or provider network/certification experience. Required Skills and Abilities: Working knowledge of word processing and spreadsheet software. Knowledge/understanding of or ability to acquire PIMS. Good judgment skills. Effective customer service and organizational skills. Demonstrated verbal and written communication skills. Basic business math proficiency. Ability to handle confidential or sensitive information with discretion. Required Software and Tools: reputed company Office. Work Environment: Typical office environment. May involve travel between office buildings. We Prefer That You Have the Following: Preferred Skills and Abilities: Ability to learn DB2, SQL language to create/run PIMS queries for QC/research purposes. Excellent telephone skills and previous Customer Service experience. Our Comprehensive Benefits Package Includes The Following: We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment. Subsidized health plans, dental and vision coverage 401k retirement savings plan with company match Life Insurance Paid Time Off (PTO) On-site cafeterias and fitness centers in major locations Education Assistance Service Recognition National discounts to movies, theaters, zoos, theme parks and more reputed company Can Do for You: We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across reputed company spectrums have the opportunity to reputed company their skills, advance their careers and contribute their unique abilities to the growth of our company. What to Expect Next: After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. Equal Employment Opportunity Statement reputed company and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national reputed company, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in reputed company phases of the employment process and to reputed company with applicable federal, state and local laws and regulations. We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-reputed company conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. If you need special assistance or an accommodation while seeking employment, please email reputed [email protected] or call 800-288-2227, ext. 47480 with the nature of your request. We will reputed company a determination regarding your request for reasonable accommodation on a case-by-case basis. We participate in E-Verify and reputed company with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information. Some states have required notifications. Here's more information. If you don’t have an account with us and don’t see the dream job you are looking for, click on the link above to reputed company by submitting your resume and contact information and we will reputed company out if we find a good fit. Welcome Here’s Your Smart Career Move Why should you join the reputed company family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with our roots firmly embedded in the South Carolina community. Business and political climates may change, but we’re stronger than reputed company. Our A.M. Best rating is A+ (Superior) — making us the only health insurance company in South Carolina with that rating. We’re the largest insurance company in South Carolina … and much more. We are one of the nation’s leading administrators of government reputed company. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining reputed company! Veterans Welcome! BlueCross is a strong supporter of our veterans, and many service men and women have joined our ranks. We’ve reputed company the dedication, work ethic and job skills that serve well in the military reputed company in many of our lines of business, and we proudly have veterans filling positions in Human Resources, Information Technology, Customer Service, Operations, General Services and more. Through our government reputed company, we also have employees serving at Shaw reputed company Force reputed company, the Naval Health Clinic in Charleston, the Naval Hospital in Beaufort and in our reputed company of Columbia, S.C., at Ft. Jackson. If you are a full-time employee in the National Guard or Reserves, we will even cover the difference in your pay if you are reputed company to active duty. Join Us If you're ready to join in a diverse company with secure, community roots and an innovative future, apply for a position now!