Enrollment Oversight & Quality Specialist (Hybrid)

Premera Blue Cross; Minnesota; Hybrid; USD 45,000 - 65,000; Full time

Benefits offered by this job

Medical, vision, dental

Life and disability insurance

401K with employer match

Pension plan after 3 years

Tuition assistance

On-site parking

On-site health and wellness center

Campus activities

Hybrid on-site resources

Job summary

Premera Blue Cross seeks an Enrollment Oversight and Quality Specialist to perform complex enrollment, eligibility, billing changes and account research with strong customer service. The role supports operations within a 7:00 AM–5:00 PM PT window and participates in late-shift coverage, coordinating with internal and external customers via phone, email, and written correspondence.

Responsibilities include audits, process improvements, and training material updates.

Qualifications

• Two years accounting/finance or enrollment processing experience preferred.
• Experience conducting audits and improving quality and efficiency.
• Knowledge of healthcare regulations and administrative guidelines.
• Collaboration with customers, partners, and cross-functional teams

Responsibilities

• Provide technical support to teams and partners by researching and troubleshooting enrollment, eligibility, billing issues.
• Research complex systems issues affecting member eligibility and determine corrective actions.
• Participate in cross-functional meetings and training to improve efficiency and processes.
• Track audit findings and action plans, ensuring timely completion and reporting.
• Update enrollment and billing records and respond to enrollment clarification requests.
• Educate agents and members on membership and billing processes and regulatory guidelines.

Skills

Customer service

Auditing

Enrollment processing

Problem solving

Education

High School diploma

Job description

Premera Blue Cross seeks an Enrollment Oversight and Quality Specialist to perform complex enrollment, eligibility, billing changes and account research with strong customer service. The role supports operations within a 7:00 AM–5:00 PM PT window and participates in late-shift coverage, coordinating with internal and external customers via phone, email, and written correspondence.

Responsibilities include audits, process improvements, and training material updates.