Enrollment Quality & Compliance Specialist

Premera Blue Cross; Arkansas; Hybrid; USD 50,000 - 66,000; Full time

Benefits offered by this job

Medical, vision, dental coverage

401K with employer match

Tuition assistance

On-site parking

Fitness & well-being center

Job summary

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to perform enrollment, eligibility, billing changes and reconciliations with a focus on accuracy and customer service. The role requires collaboration with internal teams and external partners, auditing processes, and maintaining thorough documentation.

Responsibilities include supporting audits, educating agents and members on processes, and contributing to continuous improvement initiatives within a hybrid on-site

Qualifications

• High School diploma or GED required.
• 2 years accounting/finance/bookkeeping or enrollment processing experience.
• Experience with customer service in health/insurance preferred.

Responsibilities

• Provide technical support to teams and strategic partners by researching and troubleshooting issues related to processing, systems and software.
• Research complex systems issues affecting member eligibility and determine corrective actions.
• Conduct performance audits to ensure transaction accuracy, timeliness and compliance; identify improvement opportunities.
• Educate agents and members on membership and billing processes and regulatory guidelines.
• Update eligibility, enrollment and billing records and coordinate with cross-functional teams on action plans.

Skills

Customer service

Communication

Audit & quality

Process improvement

Education

HS diploma

Job description

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to perform enrollment, eligibility, billing changes and reconciliations with a focus on accuracy and customer service. The role requires collaboration with internal teams and external partners, auditing processes, and maintaining thorough documentation.

Responsibilities include supporting audits, educating agents and members on processes, and contributing to continuous improvement initiatives within a hybrid on-site