Enrollment & Quality Assurance Specialist

Premera Blue Cross; Tallahassee (FL); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Medical, vision, and dental coverage

Life and disability insurance

401K and pension plan

Tuition assistance

On-site parking

Hybrid on-campus model

Fitness & well-being center

On-site activities

Community engagement programs

Job summary

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to improve member enrollment, eligibility and billing processes. The role involves complex audits, research, and cross-functional collaboration with strategic partners, ensuring timely, accurate transactions and adherence to regulatory guidelines.

Your responsibilities include evaluating procedures, driving improvements, and educating agents and members on enrollment and billing practices.

Qualifications

• Two years of accounting/finance/bookkeeping experience or two years enrollment processing experience.
• Health or insurance industry experience.
• Expertise in complex enrollment, eligibility, billing, and reconciliation processes.

Responsibilities

• Research and troubleshoot issues related to processing, system, and software applications.
• Conduct performance audits to ensure transaction accuracy and timeliness.
• Identify, recommend and implement process improvements.
• Represent department on cross-functional teams and meet with external customers.
• Review procedures and training materials to improve efficiency with partners.
• Update eligibility, enrollment and billing of accounts.
• Educate agents and members on enrollment and billing processes and regulatory guidelines.

Skills

Customer service experience

Enrollment processing

Accounting/finance experience

Healthcare/insurance industry

Audits and quality improvement

Cross-functional collaboration

Education

High School diploma or GED

Job description

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to improve member enrollment, eligibility and billing processes. The role involves complex audits, research, and cross-functional collaboration with strategic partners, ensuring timely, accurate transactions and adherence to regulatory guidelines.

Your responsibilities include evaluating procedures, driving improvements, and educating agents and members on enrollment and billing practices.