Job Description

: Responsible for screening, intake, processing and maintaining provider network primary source documents to ensure provider record is accurate. This position will involve processing changes, terminations, and provider roster lifecycle. Provider data accuracy audits current and prospective network providers will be performed and reported provider network management and BCBSKS audit and compliance audiences. Serve as initial intake and workflow assignment for network enrollment and completion of maintenance processes. ** This position is eligible to work hybrid (9 or more days a month onsite) in accordance with our Telecommuting Policy. Applicants must reside in Kansas or Missouri or be willing to relocate as a condition of employment. Are you ready to make a difference? Choose to work for one of the most trusted companies in Kansas. Why Join Us?

• 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 $23.00 - $27.30 Non-exempt grade 12

• Blue Cross and Blue Shield of Kansas offers excellent competitive compensation with the goal of retaining and growing talented team members. The salary 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 salaries 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

• Act as initial point of contact for intake and workflow assignment of provider network enrollment and record maintenance submissions.
• Serve as the primary contact for provider data accuracy inquiries and coordinate the resolution to update all systems relative to data accuracy.

• Perform outreach to providers verifying data accuracy utilizing e-mail, fax, phone call. Document findings on data outreach ensuring current provider data metrics identified as required or standard by the Association, CMS, federal, and state legislated guidelines, and/or BCBSKS business needs are met in all data updates.
• Educate providers on the importance of data accuracy and encourage their use of the portal for data accuracy validation.
• Complete procedures for all updates and maintenance of provider records in all systems relative to data accuracy.
• Assist in establishing and maintaining annual project plans on the continual need to ensure provider data is accurate and providers are engaged in the process.
• Participate on conference calls and audit activities related to provider data as requested.

Knowledge/Skills/Abilities

• Must be able to learn and apply network contracting knowledge throughout enrollment processing.
• Ability to work well with multiple active work items and adhere to both complimentary and competing service level agreements.
• 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 record update processing within defined quality and compliance standards.
• Must comply with corporate information security standards and guidelines relative to access control.
• Proficiency in utilizing a personal computer is required with knowledge of Microsoft Office suite products. Proficiency in use of provider records systems within six months of hire.
• Must embrace and demonstrate the company's core competencies and values of integrity, dependability, service, growth and progress, and courage.

What you need

• High school graduate or equivalent is required.
• One years of experience operational experience within BCBSKS to include customer service, claims or membership OR 2 years demonstrated experience working with clinical data management or medical insurance is required.
• Preferred experience with data verification process on extracted data or experience comparing data from multiple systems for accuracy.
• Demonstrated verbal and written communication and human relation skills with the ability to interact positively at all levels with internal and external peers.

Physical Requirements

• Some lifting of moderately heavy items up to 15 pounds relative to any printed procedure or training manuals.
• Position will be PC work up to 90% of the day to include keying, electronic communications, and virtual meeting attendance; phone usage up to 75% of the day.
• For onsite position assignment, sit / stand desk is available.

Benefits & Perks

• Base compensation is only one component of your competitive Total Rewards package
  • Incentive pay program (EPIP)
  • Health/Vision/Dental insurance
  • 6 weeks paid parental leave for new mothers and fathers
  • Fertility/Adoption assistance
  • 2 weeks paid caregiver leave
  • 5% 401(k) plan matching
  • Tuition reimbursement
  • Health & fitness benefits, discounts and resources

Our Commitment to Diversity, Equity, Inclusion, and Belonging At Blue Cross and Blue Shield of Kansas, we are committed to fostering a culture of diversity, equity, inclusion, and belonging (DEIB), where mutual respect is at the foundation of our workplace. We provide equal employment opportunities to all individuals, regardless of race, color, religion, belief, sex, pregnancy (including childbirth, lactation, and related medical conditions), national origin, age, physical or mental disability, marital status, sexual orientation, gender identity, gender expression, genetic information (including characteristics and testing), military or veteran status, family or parental status, or any other characteristic protected by applicable law. We believe that embracing diversity and authentically promoting inclusion, equity, and belonging among our team members is crucial to our collective success. By intentionally recruiting, developing, and retaining a diverse pool of talent, we cultivate an environment where everyone feels valued, heard, and empowered to contribute. Accommodations are available for applicants with disabilities upon request, ensuring an inclusive and accessible hiring process for all.

Job Tags

Similar Jobs