Enrollment Oversight & Quality Specialist

Premera Blue Cross; Minneota (MN); On-site; USD 52,000 - 68,000; Full time

Benefits offered by this job

Medical, vision, dental coverage

401K employer match and pension plan

Tuition assistance for undergrad and

On-site parking

Hybrid/onsite flexibility

On-site wellness center and fitness/NH

Job summary

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to handle complex enrollment, eligibility, billing changes, and reconciliations with accuracy and professional communication. The role emphasizes audits, regulatory guidance, and collaborative problem solving with internal teams and external partners.

Ideal candidates will combine strong customer service with process improvement mindset, participate in late shifts as needed, and contribute to training and quality

Qualifications

• High School diploma or GED with two years in accounting/finance or enrollment processing.
• Experience in audits and improving quality and efficiency.
• Healthcare regulations and administrative guidelines knowledge.
• Collaborates with customers, partners, and cross-functional teams.

Responsibilities

• Provide technical support to teams by researching and troubleshooting issues.
• Research complex systems issues impacting member eligibility and determine actions.
• Conduct performance audits for compliance, accuracy, and timeliness.
• Represent department on cross-functional teams and meet with external customers.
• Review procedures and training materials to improve efficiency in partnership with training/QA teams.
• Update eligibility, enrollment and billing records and contact customers or agents for clarification.
• Educate agents and members on membership and billing processes.

Skills

Customer service

Research issues

Communication

Auditing

Process improvement

Cross-functional collaboration

Regulatory knowledge

Education

High School diploma or GED

Two years accounting/finance experience

Enrollment processing experience

Tools

Healthcare IT systems

Job description

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to handle complex enrollment, eligibility, billing changes, and reconciliations with accuracy and professional communication. The role emphasizes audits, regulatory guidance, and collaborative problem solving with internal teams and external partners.

Ideal candidates will combine strong customer service with process improvement mindset, participate in late shifts as needed, and contribute to training and quality