Enrollment Processing Specialist - Hybrid Advanced

Blue Shield of California; California (MO); Hybrid; USD 64,501,000 - 90,346,000; Full time

Job summary

Blue Shield of California is seeking an Enrollment Processor Advanced to process member enrollments and eligibility data, ensuring billing accuracy. The role reports to the Operations Supervisor and involves work with automated systems under defined production standards.

Hybrid virtual role requiring occasional office visits to support scheduling, reporting, and collaboration with internal partners. Candidates should have strong data skills and knowledge of medical plans and benefits.

Qualifications

• Requires High School Diploma or GED.
• Requires at least 5 years of prior relevant experience.
• Intermediate-Advanced skills creating documents/files using Excel, Outlook, Power Point, and Word.
• Knowledge of medical plans and benefits.

Responsibilities

• Verify accuracy of entered data against source documents.
• Look up correct codes and enter data into system.
• Process member level enrollment and cancellations.
• Make decisions based on review of source documents for routine and difficult processing issues.
• Assist in monitoring schedules, workflow, and priorities, communicating with supervisors/team members as needed to ensure effective teamwork.
• Use daily reports, tools, and applications to manage eligibility for non-electronic and electronic groups.
• Prepares reports as directed by supervisor or manager to communicate information internally or externally.

Education

High School Diploma or GED

Tools

Excel

Outlook

PowerPoint

Word

Job description

Blue Shield of California is seeking an Enrollment Processor Advanced to process member enrollments and eligibility data, ensuring billing accuracy. The role reports to the Operations Supervisor and involves work with automated systems under defined production standards.

Hybrid virtual role requiring occasional office visits to support scheduling, reporting, and collaboration with internal partners. Candidates should have strong data skills and knowledge of medical plans and benefits.