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Job Description

The Provider Operations processer is primarily accountable for validating and data entering information supplied by providers, provider organizations, and internal BCBSMA associates in support of enrollment, credentialing or update of provider information. The position is primarily responsible for ensuring that the practitioner/provider has met all appropriate guidelines including BCBSMA policies and procedures, and adherence to the guidelines and requirements of Massachusetts State Laws, the Center for Medicare Services (CMS), National Committee for Quality Assurance (NCQA) and other governing entries prior to updating data.


This position is eligible for the following personas: Resident, Mobile, and eWorker.


Key Responsibilities:

+ Validate and data enter provider enrollment, credentialing and maintenance related data for practitioners and provider...