Enrollment & Quality Assurance Specialist

Premera Blue Cross; Iowa; Hybrid; USD 55,000 - 75,000; Full time

Benefits offered by this job

Health insurance

Dental coverage

401(k) with match

Tuition assistance

On-site parking

Well-being center

Job summary

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to handle enrollment, eligibility, billing changes and account research using multiple platforms.

The role emphasizes exceptional customer service via phone, email, or written correspondence within established timelines and requires explaining complex regulatory guidelines to members and agents, with audits and process improvements driving efficiency.

Qualifications

• Two years accounting/finance/bookkeeping experience or enrollment processing experience.
• Experience in health or insurance industries is preferred.
• Ability to understand and explain enrollment, eligibility, billing processes and regulatory guidelines.

Responsibilities

• Provide technical support to teams and implementation partners on processing, systems and software.
• Research complex system issues affecting member eligibility and determine corrective actions.
• Conduct performance audits to ensure accuracy, timeliness and compliance of transactions.
• Collaborate with cross-functional teams and external customers; participate in training material reviews.
• Complete special projects and track audit findings with action plans to closure.
• Update enrollment, eligibility and billing information across systems.

Skills

Customer service

Auditing

Research & problem-solving

Education

High School diploma or GED

Job description

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to handle enrollment, eligibility, billing changes and account research using multiple platforms.

The role emphasizes exceptional customer service via phone, email, or written correspondence within established timelines and requires explaining complex regulatory guidelines to members and agents, with audits and process improvements driving efficiency.