Summary
 

As a Provider File Operations Supervisor, you will supervise provider enrollment and quality assurance staff.  You will ensure providers are loaded accurately and timely into system, appropriately assigned to networks, and updated correctly when necessary. You will also manage activities related to the provider file including file maintenance, quality assurance, credentialing, electronic funds transfer payment, provider directories, and applicable contract related requirements.

Description
 

Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we have been part of the national landscape, 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 contracts. 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 committed to the same philosophy, consider joining our team!

Here is your opportunity to join a dynamic team at a diverse company with secure, community roots and an innovative future.

Logistics:

This position is onsite at 17 Technology Circle, Columbia, SC 29203. The hours are 8:00 a.m. – 5:00 p.m. Monday – Friday.

What You’ll Do:

• Oversee credentialing.
• Manage updates and maintenance of various other provider databases to ensure accurate reimbursement, network assignment, online and printed directories, and information for marketing disruption and member access studies also.
• Make recommendations and executes changes to meet work requirements.
• Develop, implement, and complete all inventory, production, error, and tracking reports.
• Supervise, motivate, train, and assist staff with questions.
• Responsible for recruiting and hiring, coaching and mentoring, monitoring and evaluation, and addressing all disciplinary issues in a timely manner.
• Encourage staff in creating and maintaining a work environment with high morale and employee satisfaction through support of professional development, training, career growth, and rewarding high performance.
• Research and respond to provider related inquiries from internal and external sources.
• Participate in system design, fulfillment of contract requirements, and in ongoing system testing.

To Qualify for This Position, You’ll Need:

• Bachelor's degree in a job-related field OR 4 years job related work experience OR Associate's and 2 years job related work experience.
• 3 years of provider network experience utilizing integrated computer systems.
• Excellent verbal and written communication skills.
• Excellent organizational, customer service, and presentation skills.
• Excellent analytical or critical thinking skills.
• Good judgment skills.
• Proficiency in spelling, grammar, and punctuation.
• Ability to persuade, negotiate, or influence others.
• Ability to handle confidential or sensitive information with discretion.
• Knowledge of provider credentialing process.
• Experience with Microsoft Office.
• Knowledge of computer systems support.

What We Prefer:

• Knowledge of mathematical or statistical concepts.
• Ability to use complex mathematical calculations.
• 3 years of MAC (Medicare Administrator Contractor) experience.
• Experience using Microsoft Excel.

What We can Do for You:

• 401(k) retirement savings plan with company match.
• Subsidized health plans and free vision coverage.
• Life insurance.
• Paid annual leave – the longer you work here, the more you earn.
• Nine paid holidays.
• On-site cafeterias and fitness centers in major locations.
• Wellness programs and healthy lifestyle premium discount.
• Tuition assistance.
• Service recognition.
• Incentive Plan.
• Merit Plan.
• Continuing education funds for additional certifications and certification renewal.

What to Expect Next:

After submitting your application, our recruiting team members will review your resume to ensure your meet the qualifications.  This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.

Management will be conducting interviews with the most qualified candidates, with prioritization give to those candidates who demonstrate the preferred qualifications.

 

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.

Some states have required notifications. Here's more information. 

Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, 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 minorities, females, disabled individuals and veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities.

If you need special assistance or an accommodation while seeking employment, please e-mail [email protected] or call 1-800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.