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Representative, Provider Relations

BlueCross BlueShield of South Carolina
life insurance, paid holidays, tuition assistance, 401(k)
United States, South Carolina, Columbia
Nov 09, 2024
Summary As a Provider Relations Representative, you will provide education and training support for network providers/staff/suppliers/physicians/beneficiaries/referral agents as necessary. You will also develop and produce training and educational materials. 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:

  • Develop/prepare/review/update all provider education materials. These may include: new highlights, calendar of events, job aids, resource tools, and web page content. conducts/facilitates workshops, training class materials in support of teleconferences with providers, provider groups, staff, suppliers, physicians, beneficiaries, referral agents.
  • Support relationships with providers, provider groups, staff, suppliers, physicians, beneficiaries, referral agents, state/local medical/professional associations.
  • Responds to educational needs.
  • Perform administrative functions in support of education and training. Produce/generate various reports to management and provides feedback on activities to management.
  • Contribute/participate/complete special projects as assigned.

To Qualify for This Position, You'll Need:

  • Bachelor's degree OR four years of job-related experience OR a combination of education and experience.
  • Two years of experience in customer service, claims processing, communications, education/training, provider relations, healthcare, or a combination.
  • Experience working with Fee for Service Knowledge (Medicaid Provider Enrollment).
  • Demonstrated skills related to training materials development.
  • Demonstrated skills related to classroom presentations to large groups.
  • Demonstrated proficiency in word processing and spreadsheet software.
  • Good judgment skills.
  • Effective customer service, organizational, and presentation skills.
  • Demonstrated verbal and written communication skills.
  • Analytical and critical thinking skills.
  • Basic business math proficiency.
  • Ability to persuade, negotiate, or influence others.
  • Ability to handle confidential or sensitive information with discretion.
  • Ability to identify learning objectives.
  • Strong course design skills to include use of media/other instructional methods.
  • Ability to evaluate progress in addition to actual delivery of training sessions.
  • Microsoft Office Suite including extensive working knowledge of Excel.

What We Prefer:

  • Knowledge of claims processing, government healthcare programs.
  • Ability to acquire working knowledge/understanding of specific programs.
  • Ability to acquire working knowledge/understanding of Medicaid, Medicare.
  • Ability to acquire working knowledge/understanding of HIPAA policies/procedures.

Required License and Certificates:

  • Driver's License must be obtained within 60 days of hire in state employed. Licensure must be maintained while in job. Other licensures and certifications may be required and maintained by specific areas.

Work Environment:

  • Frequent day travel, up to 70%.
  • Work will involve day travel, meetings, and transportation of materials.

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 mycareer.help@bcbssc.com 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.

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