Enrollment Quality Assurance Specialist

Premera Blue Cross; Georgia; Hybrid; USD 48,000 - 72,000; Full time

Benefits offered by this job

Medical, vision, dental coverage

Life and disability insurance

401K with employer match

Tuition assistance

On-site parking

Well-being center

On-site activities

Job summary

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to handle complex enrollment, eligibility and billing changes while researching accounts across multiple systems. The role emphasizes exceptional customer service and timely responses to members and agents.

You will participate in audits, update procedures, and drive efficiency improvements with internal teams and strategic partners, supporting operations within a Pacific Time window and occasional late shifts.

Qualifications

• Minimum of a high school diploma or GED.
• 2 years accounting/finance/bookkeeping experience or enrollment processing experience.
• Experience in health or insurance industry preferred.
• Knowledge of healthcare regulations and administrative guidelines beneficial.

Responsibilities

• Perform moderate to complex enrollment, eligibility, billing changes and reconciliations.
• Explain administrative and regulatory guidelines to members/agents clearly.
• Develop, maintain, and track audits, procedures and efficiency improvements.
• Support business operations during 7:00 AM–5:00 PM PT and participate in late-shift rotations.
• Collaborate with internal teams and external partners on system issues and process improvements.
• Provide training and updates to teammates and strategic implementation partners.

Skills

Customer service

Audits

Enrollment processing

Healthcare regulations

Cross-functional collaboration

Education

High School diploma or GED

Job description

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to handle complex enrollment, eligibility and billing changes while researching accounts across multiple systems. The role emphasizes exceptional customer service and timely responses to members and agents.

You will participate in audits, update procedures, and drive efficiency improvements with internal teams and strategic partners, supporting operations within a Pacific Time window and occasional late shifts.