Enrollment Quality Assurance Specialist

Premera Blue Cross; Madison (WI); On-site; USD 55,000 - 70,000; Full time

Benefits offered by this job

Health benefits

401K & pension plan

Tuition assistance

On-site parking

Wellness center

Campus activities

Job summary

Premera Blue Cross in Wisconsin seeks an Enrollment Oversight and Quality Specialist to manage enrollment, eligibility, billing changes, and reconciliations across systems. You will provide technical support to teams and partners, researching issues and ensuring compliance with administrative guidelines.

The role requires strong customer service, effective communication, and ability to educate members and agents on complex enrollment topics. Hybrid/ onsite work options may apply.

Qualifications

• Minimum of a High School diploma or GED.
• At least two years of accounting/finance/bookkeeping experience or enrollment processing experience.
• Health or insurance industry experience preferred.
• Expertise in complex enrollment, eligibility, billing, and reconciliation processes.

Responsibilities

• Perform moderate to complex enrollment, eligibility, billing changes and reconciliation; conduct audits and improve related processes.
• Provide technical support to teams and strategic implementation partners; troubleshoot processing, system, and software issues.
• Educate agents and members on enrollment processes and regulatory guidelines; explain options and policies.
• Track audit findings, action plans and information requests to ensure timely completion.

Skills

Customer service

Attention to detail

Communication

Audits & quality

Education

High School diploma or GED

Tools

Web portal

Job description

Premera Blue Cross in Wisconsin seeks an Enrollment Oversight and Quality Specialist to manage enrollment, eligibility, billing changes, and reconciliations across systems. You will provide technical support to teams and partners, researching issues and ensuring compliance with administrative guidelines.

The role requires strong customer service, effective communication, and ability to educate members and agents on complex enrollment topics. Hybrid/ onsite work options may apply.