Provider Network Enrollment Specialist

Responsible for the prompt, courteous, accurate and timely enrollment processing for network providers engaging as contracting within all networks within BCBSKS; including recording and tracking contracts in the Provider Network Solutions suite of record systems. Be familiar with BCBSKS contract offerings. Reviews and assesses network enrollment eligibility. Assists providers with questions regarding network contracting and enrollment processes. Serve as internal corporate resource for questions concerning network participation guidelines.

Coordinate new enrollment completion with Provider Network Solutions Provider Representatives to engage new providers and complete onboarding experience.
** Why Join Us**
* ** Make a Positive Impact:
** Your work will directly contribute to the health and well-being of Kansans.
* ** Family*
* ** Comes First**:
Total rewards package that promotes the idea of family first for all employees.
* ** Professional Growth Opportunities:
** Advance your career with ongoing training and development programs.
* ** Dynamic Work Environment:
** Collaborate with a team of passionate and driven individuals.
* ** Trust:
** Work for one of the most trusted companies in Kansas
* ** Stability:
** 80 years of commitment, compassion and community
** Compensation**$23.58 - $29.40 hourly  Non-Exempt 12
* Blue Cross and Blue Shield of Kansas offers excellent competitive compensation with the goal of retaining and growing talented team members. The compensation range for this role is a good faith estimate, it is estimated based on what a successful candidate might be paid.  All offers presented to candidates are carefully reviewed to ensure fair, equitable pay by offering competitive wages that align with the individual's skills, education, experience, and training.

The range may vary above or below the stated amounts.
** What you’ll do
*** Responds to provider network enrollment inquiries to initiate enrollment onboarding activities.
* Perform research to validate eligibility for BCBSKS contracting and network enrollment. Ensures enrollment eligibility as required by or standard by the Association, CMS, federal, and state legislated guidelines, and/or BCBSKS business needs compliance regulations.
* Complete network enrollment lifecycle activities including initial quality review, validation of required licenses, accreditation compliance, NPI registration, and board certification, record creation and coordination of onboarding completion.
* Create and maintain provider records in the network management systems to facilitate enrollment and audit documentation review.
* Educate and assist internal users and consumers of provider network contract and record information.
* Responsible for understanding the network contract variables offered and serviced by BCBSKS to ensure application and enrollment to correct networks as contracted.
* Complete annual health plan accreditation education / training on job functions included as part of the accreditation standards relative to provider network. Must be able to comply with accreditation standards as required for job functions.
* Perform provider record audits as identified projects require. Assist with provider communications as needed.
** What you need**###
** Knowledge/Skills/Abilities
*** Must be able to learn and apply provider network contracting knowledge throughout enrollment processing for BCBSKS owned and serviced contracts.
* Ability to perform detailed research and gather supporting documentation, to provide network contract eligibility recommendations.
* Ability to work well with multiple active work items and adhere to both complimentary and competing service level agreements.
* Ability to communicate effectively with staff from provider offices, physicians, and all levels of internal staff required.
* Employ independent and procedural thinking skills to complete records within defined data entry systems.
* Understand sequential workflow procedures.
* Work with high degree of accuracy to complete enrollment processing within defined quality and compliance standards.
* Must comply with corporate information privacy and security standards and guidelines…