Provider Enrollment Serv Rep Job Vacancy in Blue Cross Blue Shield of Michigan Southfield, MI – Latest Jobs in Southfield, MI
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Company Name : Blue Cross Blue Shield of Michigan
Location : Southfield, MI
Position : Provider Enrollment Serv Rep
Job Description : Non-Exempt/Bargaining Unit Posting
Local/Seniority Unit – 1781/0000
Date Posted Internal – 2/8/22, Deadline Date – 2/15/22
Department – 150400 Prov Ops and Innovation
Salary Grade – UF
Job Code – C4
Number of openings – 3
Shift – 1st shift
Site/Location: BCN Commons
Status – Regular Full Time
Identify, analyze and monitor provider issues and concerns; recommend solutions and work with inter/intra departmental personnel to resolve issues. Provide education and guidance to providers regarding enrollment policies and procedures via the telephone servicing inquiry process and assist with processing enrollments and changes.
Analyze, evaluate, resolve and respond to provider inquiries received via telephone and through correspondence involving a variety of provider enrollment and data issues under BCBSM and BCN products.
Initiate status reports and service recovery when delays occur in responding to an inquiry.
Educate providers on how to complete various enrollment transactions through daily inquiries.
Document provider contacts through the departmental tracking systems following departmental procedures.
Assist with processing Practitioner Changes, Provider Changes, Facility Changes, CAQH updates, Re-Enrollments, Signature documents and perform special projects through using various systems.
Organize work to meet departmental production and quality standards and follows departmental reporting requirements.
Interface with inter/intra departmental personnel to resolve inquiries and claim related problems.
Perform basic enrollment and data management online production transactions to resolve issues or to perform ongoing data update support.
Qualifications
Associates Degree (or 2 years college) preferred.
One (1) year experience directly related work experience, such as public/customer service, provider enrollment, claims processing and, one (1) year of direct public contact position such as teaching, banking, or medical/office assistant.
Working knowledge of BCBSM and BCN provider enrollment policies and procedures, including initial enrollment and ongoing data maintenance preferred.
Working familiarity with Portico preferred.
Basic knowledge of PC applications (Word & Excel), required.
Problem solving and analytical skills necessary to analyze data and resolve problems related to inquiry and claims.
Demonstrated command of all skills necessary for oral and written communications with providers in grammatically correct, clear, concise and tactful manner.
All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability.
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