Enrollment Quality Assurance Specialist

Premera Blue Cross; Arkansas; On-site; USD 50,000 - 65,000; Full time

Benefits offered by this job

Medical, vision, and dental coverage

Life and disability insurance

401K with employer match and pension

Tuition assistance

On-site parking

On-site health and wellness facilities

Job summary

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to perform enrollment, eligibility, billing changes, and reconciliation, using various systems. The role requires strong customer service and clear explanation of guidelines to members and agents.

You will participate in audits, develop and track procedures, train teams and partners, and support strategic implementation. The schedule includes 7:00 AM–5:00 PM PT with one late shift per week.

Qualifications

• High School diploma or GED; 2 years in accounting/finance or enrollment processing.
• Experience in customer service and healthcare/insurance is preferred.
• Knowledge of complex enrollment, eligibility, billing and reconciliation processes.
• Experience conducting audits and improving quality and efficiency.
• Familiarity with healthcare regulations and administrative guidelines.
• Ability to collaborate with customers, partners and cross-functional teams.

Responsibilities

• Provide technical support to assigned teams/partners by researching issues related to processing and software applications.
• Research complex system issues affecting member eligibility and determine action, audit performance for compliance, and suggest improvements.
• Represent department on cross-functional teams and meet with external customers as required.
• Review procedures and training material to outline improvements with training teams and partners.
• Complete special projects and other duties as assigned.
• Track audit findings and action plans to ensure timely completion.

Skills

Customer service

Communication

Analytical thinking

Cross-functional collaboration

Education

High School diploma or GED

Two years accounting/finance or enrollment processing experience

Tools

Enrollment systems

Billing platforms

Job description

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to perform enrollment, eligibility, billing changes, and reconciliation, using various systems. The role requires strong customer service and clear explanation of guidelines to members and agents.

You will participate in audits, develop and track procedures, train teams and partners, and support strategic implementation. The schedule includes 7:00 AM–5:00 PM PT with one late shift per week.