Provider File Specialist

Position: Provider File Specialist I
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*
* Location:

** This position is full-time (40-hours/week) Monday-Friday in a typical office environment. 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 Boulevard Florence, SC 29501.
**** SCA Benefit Requirements:
** Blue Cross Blue Shield of South Carolina and its subsidiary companies have contracts 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.
* 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 rate updates, quality improvement, audits, etc.
* ** Required

Education:

** High School Diploma or equivalent
* ** Degree Equivalency:**
* *
* Required Experience:

** 1 year of administrative/clerical support, customer service, claims processing, and/or provider network/certification experience.
* ** Required Software and Other Tools:
** Microsoft Office
* ** 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.
* 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
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