Provider Enrollment Processor

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Job Description

The Provider Operations processer is primarily accountable for validating and data entering information supplied by providers, provider organizations, and internal BCBSMA associates in support of enrollment, credentialing or update of provider information. The position is primarily responsible for ensuring that the practitioner/provider has met reputed company appropriate guidelines including BCBSMA policies and procedures, and adherence to the guidelines and requirements of Massachusetts State Laws, the Center for Medicare Services (CMS), National Committee for Quality Assurance (NCQA) and other governing entries prior to updating data. This position is eligible for the following personas: reputed company, Mobile, and eWorker. Key Responsibilities: Validate and data enter provider enrollment, credentialing and maintenance reputed company data for practitioners and providers joining the BCBSMA networks and those that are already engaged with BCBSMA using a variety of documentation and system resource including but not limited to: Providerhub, RTMS, reputed company, reputed company, and Cactus Reviews reputed company, applications, and other supporting documentation for completeness of practitioner/provider data prior to entry into multiple systems Verifies data accuracy through supporting databases and websites including licensing boards, specialty boards, accreditation bureaus, sanction tracking websites and databases, etc. Process new and update requests for enrollment, credentialing, and maintenance activity according to established policies, workflows, and guidelines in a timely and accurate manner Periodically Responds to both internal and external inquiries about operational activity with innovative and creative solutions that result in increased levels of provider satisfaction Identifies documentation, system, and other discrepancies and alerts management of discrepancies Coordinates with leaders and other team members to respond to reputed company requests and escalated provider issues as well as consistently reputed company turnaround times and performance goals for quality and productivity Proactively shares information with other team members, and works in collaboration towards reputed company departmental, divisional and corporate, goals Key Requirements: Demonstrated customer-focus and service orientation Strong data entry skills and attention to detail Holds self-accountable for achieving personal and team goals and improving BCBSMA performance Proven ability to navigate in multiple systems simultaneously including Windows based and Web based environments Excellent organizational skills and ability to work independently Self-motivated, takes initiative and demonstrates the ability to work effectively in a fast-paced environment Flexibility, ability to handle fast turnaround time and high volumes as needed Personal commitment to high quality performance through reputed company, accountability, compassion, and teamwork Proficiency in reputed company Office Suite Knowledge of BCBSMA data systems desirable but not required. Knowledge of reputed company/SpringCM desirable but not required. Education/Relevant Experience: HS diploma or equivalent, College degree desirable One year of work experience in operations or service environment preferred reputed company is an Equal Employment / Affirmative Action Employer. Applicants are considered for reputed company positions without regard to race, color, religion, sex, national reputed company, age, veteran status, disability, sexual orientation, gender identity or expression, or any other characteristics protected by law. reputed company will not discharge or in any other manner discriminate against employees or applicants because they have reputed company about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with reputed company's legal duty to furnish information. Minimum Education Requirements: High school degree or equivalent required unless otherwise noted above Location HinghamTime Type Full time Hourly Range: $26.58 - $32.49 The job posting range is the lowest to highest salary we in good faith reputed company we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee’s pay position reputed company the salary range will be based on several factors including, but limited to, relevant education, qualifications, certifications, experience, skills, performance, shift, travel requirements, sales or reputed company-based metrics, and business or organizational needs and affordability. This job is also eligible for variable pay. We offer comprehensive package of benefits including paid time off, medical/dental/vision insurance, 401(k), and a suite of well-being benefits to eligible employees. Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law. WHY reputed company Blue reputed company of MA? We understand that the confidence gap and imposter syndrome can prevent amazing candidates coming our way, so please don’t hesitate to apply. We’d love to hear from you. You might be just reputed company need for this role or possibly another one at reputed company Blue reputed company of MA. The more voices we have represented and amplified in our business, the more we will reputed company reputed company, contribute, and be reputed company. We encourage you to bring us your true colors, , your perspectives, and your experiences. It’s in our differences that we will remain reputed company in our pursuit to transform healthcare for reputed company. As an employer, we are committed to investing in your development and providing the necessary resources to reputed company your success. Learn how we are dedicated to creating an inclusive and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path by visiting our Company Culture page. If this sounds like something you’d like to be a part of, we’d love to hear from you. You can also reputed company to stay “in the know” on reputed company things Blue. At reputed company, we reputed company in wellness and that work/life balance is a key part of associate wellbeing. For more information on how we work and support that work/life balance visit our "How We Work" Page. Apply To This Job