Enrollment Quality & Compliance Specialist

Premera Blue Cross; Little Rock (AR); On-site; USD 52,000 - 64,000; Full time

Benefits offered by this job

Medical, vision, and dental coverage

401K employer match

Pension plan

Tuition assistance

On-site parking

Job summary

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to handle enrollment, eligibility, billing changes, and account research. You will provide technical support across systems and partner with internal and external customers, ensuring timely, accurate processing and adherence to guidelines.

The role emphasizes audits, quality improvements, and collaboration with strategic partners, with a focus on member satisfaction and compliant operations within standard procedures.

Qualifications

• High School diploma or GED is required; two years accounting/finance or enrollment processing experience preferred.
• Experience with health insurance enrollment, eligibility, billing and reconciliation processes is advantageous.
• Strong customer service skills and ability to explain complex guidelines to members/agents.

Responsibilities

• Perform moderate to complex enrollment, eligibility, billing changes and reconciliation on accounts.
• Conduct audits and track procedures to improve efficiency with internal partners.
• Provide technical support for processing systems and software applications used by teams.
• Research complex system issues impacting member eligibility and determine actions.
• Coordinate with cross-functional teams and external customers as needed.
• Update eligibility, enrollment and billing information and respond to inquiries.
• Educate agents and members on membership and billing processes and portal usage.
• Work within department turnaround times and meet production/quality standards.

Skills

Customer service

Enrollment processing

Billing & reconciliation

Audit & quality improvement

Cross-functional collaboration

Explain regulatory guidelines

Education

High School diploma or GED

2 years accounting/finance/bookkeeping or enrollment processing experience

Job description

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to handle enrollment, eligibility, billing changes, and account research. You will provide technical support across systems and partner with internal and external customers, ensuring timely, accurate processing and adherence to guidelines.

The role emphasizes audits, quality improvements, and collaboration with strategic partners, with a focus on member satisfaction and compliant operations within standard procedures.