Enrollment Quality Assurance Specialist

Premera Blue Cross; Nevada; On-site; USD 60,000 - 80,000; Full time

Benefits offered by this job

Health insurance

401(k) plan

On-site parking

Tuition assistance

Hybrid option for some roles

Job summary

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to perform enrollment, eligibility, billing changes, and reconciliations with strong customer service across multiple platforms. You will audit processes, educate members and agents, and participate in cross-functional teams to improve efficiency and ensure regulatory compliance.

The role requires supporting a 7:00 AM–5:00 PM PT window with late shifts about one day per week and occasional additional coverage.

Qualifications

• Two years of accounting/finance/bookkeeping experience or enrollment processing experience.
• Health or insurance industry experience.
• Expertise in complex enrollment, eligibility, billing, and reconciliation processes.
• Experience conducting audits and improving quality and efficiency.
• Knowledge of healthcare regulations and administrative guidelines.
• Collaboration with customers, partners, and cross-functional teams.

Responsibilities

• Provides technical support to assigned teams and strategic implementation partners by researching and troubleshooting issues related to processing, system, and software applications.
• Represents department on cross-functional teams and meets with external customers as required.
• Regularly reviews procedures and training material to outline and implement improvements for increased efficiency.
• Update eligibility, enrollment and/or billing of accounts.
• Educate agents and members on membership and billing processes and administrative rules.

Skills

Customer service

Audits

Communication

Cross-functional collaboration

Education

High School diploma or GED

Job description

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to perform enrollment, eligibility, billing changes, and reconciliations with strong customer service across multiple platforms. You will audit processes, educate members and agents, and participate in cross-functional teams to improve efficiency and ensure regulatory compliance.

The role requires supporting a 7:00 AM–5:00 PM PT window with late shifts about one day per week and occasional additional coverage.