Provider Enrollment Serv Rep

With more than 7,000 employees, we are the largest health insurance company in Michigan. We offer an exciting work environment with a diverse group of employees. Our goal is to make health insurance easier for our members. We want to transform the industry and become a resource that people can trust.

Southfield, MI

Blue Cross Blue Shield of Michigan

When you think of <a href="" target="_blank" rel="noopener noreferrer">Blue Cross Blue Shield of Michigan</a> for health insurance, you can know you&rsquo;re getting much more. We're a company founded on a tradition of affordable, quality health care for everyone, improving the present and investing in the future.&nbsp;<br /><br />We offer:<br />Plans for employers and individuals that meet today&rsquo;s needs, budgets and lifestyle<br />The largest network of doctors and hospitals in the state<br />Lower health care costs Higher quality health care<br />Award-winning diversity practices<br />Grants and programs that promote better health throughout Michigan<br /><strong><br />Mission:&nbsp;</strong>We commit to being our members&rsquo; trusted partner by providing affordable, innovative products that improve their care and health.<br /><br /><a href="" target="_blank" rel="noopener noreferrer"><strong>Click here</strong></a> to learn more about our commitment to our Social Mission, view company updates and reviews, and view our awards &amp; accolades.<br /><br />For Application Timeline &amp; Selection Process:&nbsp;<a href="" target="_blank" rel="noopener noreferrer">Click Here</a>. Learn more about your options as an external candidate. <a href="" target="_blank" title="BCBSM" rel="noopener noreferrer">Click here</a> to view open positions.

keywords: job posting,departmental summary,analyze,assist,duties,departmental preferences,departmental requirements,knowledge & skills


Competitive Total Compensation Package

Overview: <strong>Departmental Summary</strong><br /><br /> <ul> <li>Non-Exempt/Bargaining Unit Posting Local/Seniority Unit &ndash; 1781/0000 Date Posted Internal &ndash; 12/1/22, Deadline Date &ndash; 12/8/22 Department &ndash; 150380 Prov Enr Cred Cont Ops Salary Grade &ndash; UF Job Code. C4 Number of openings &ndash; 1 Shift &ndash; shift bidding process based on seniority Site/Location: BCN Commons Status &ndash; Regular Full Time.</li> <li>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.</li> </ul>
Responsibilities: <strong>Departmental Preferences&nbsp;</strong><br /><br /> <ul> <li>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.</li> <li>Initiate status reports and service recovery when delays occur in responding to an inquiry.</li> <li>Educate providers on how to complete various enrollment transactions through daily inquiries.</li> <li>Document provider contacts through the departmental tracking systems following departmental procedures.</li> <li>Assist with processing Practitioner Changes, Provider Changes, Facility Changes, CAQH updates, Re-Enrollments, Signature documents and perform special projects through using various systems.</li> <li>Organize work to meet departmental production and quality standards and follows departmental reporting requirements.</li> <li>Interface with inter/intra departmental personnel to resolve inquiries and claim related problems.</li> <li>Perform basic enrollment and data management online production transactions to resolve issues or to perform ongoing data update support.&nbsp;</li> </ul>
Requirements: <strong><strong>Departmental Requirements<br /></strong></strong><br />Qualifications- <br /> <ul> <li>Associates Degree (or 2 years college) preferred.</li> <li>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.</li> <li>Working knowledge of BCBSM and BCN provider enrollment policies and procedures, including initial enrollment and ongoing data maintenance preferred.</li> <li>Working familiarity with Portico preferred.</li> <li>Basic knowledge of PC applications (Word &amp; Excel), required.</li> <li>Problem solving and analytical skills necessary to analyze data and resolve problems related to inquiry and claims.</li> <li>Demonstrated command of all skills necessary for oral and written communications with providers in grammatically correct, clear, concise and tactful manner.&nbsp;</li> </ul>