Job details

Provider Information Mgmt Rep Assoc

About Blue Cross

Blue Cross and Blue Shield of Minnesota is one of the most recognized and trusted health care brands in the world with 2.5 million members. We’re committed to reinventing health care to improve health for our members and the community. We hope you'll join us.

How Is This Role Important to Our Work?
This position is responsible for reviewing and auditing provider contracts to ensure they are current.

A Day in the Life:

Accurately setup and maintaining provider and practitioner information on the provider database with varying complexity.
Resolve all standard and some non-standard inquiries from clients.
Follow outlined business rules to ensure data integrity. Work can be frequently non routine but usually limited impact.
Works directly with large groups and delegated providers.
Generally, works under direct supervision.
Work cohesively with other departments within BCBSMN to ensure accurate and timely resolution.
Handle claims within timely manner accurately and appropriately to meet legislative and corporate guidelines.
Ensures compliance with National Committee on Quality Assurance (NCQA), CMS, DOH regulations, BCBS, internal and private business audits.
Manage projects driven by leadership at a departmental or corporate level, and ensure that all projects and assigned work is completed in a timely and accurate.

Nice to Have:

Experience with Provider Profiles and Symplr Payer.
Customer service experience with Windows based software applications.

Role Designation:

Teleworker

Role designation definition: Teleworking is working full time remote. Hybrid is a combination of working onsite and remotely. Onsite is full-time onsite.

Make a difference

Blue Cross is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, gender expression, or any other legally protected characteristic.

Reasonable Accommodation for Job Seekers with a Disability: If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to talent.acquisition@bluecrossmn.com.

All roles require a high school diploma (or equivalency) and legal authorization to work in the U.S.

Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association.