Enrollment Quality & Compliance Specialist

Premera Blue Cross; Michigan; Hybrid; USD 50,000 - 80,000; Full time

Benefits offered by this job

Medical, vision, and dental coverage

401K with employer match

Pension plan after 3 years

Tuition assistance

On-site parking

Job summary

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to handle enrollment, eligibility, and billing changes with high attention to accuracy and timeliness. The role requires strong customer service, auditing skills, and the ability to work with internal teams and external customers.

The position supports operations during a 7:00 AM to 5:00 PM PT window with a rotating late shift. Hybrid on-site work is available, with on-campus resources and training opportunities to

Qualifications

• High School diploma or GED; 2+ years accounting/finance, enrollment processing or customer service experience.
• Experience with audits and improving quality/efficiency.
• Knowledge of healthcare regulations and administrative guidelines.
• Ability to collaborate with customers, partners, and cross-functional teams.

Responsibilities

• Provide technical support to teams and partners by researching/troubleshooting enrollment, eligibility, and billing issues.
• Research complex systems issues affecting member eligibility; conduct performance audits for compliance and timeliness.
• Represent department on cross-functional teams and engage with external customers as needed.
• Review training materials to improve efficiency and partner with training/quality teams.
• Update eligibility, enrollment, and billing records; communicate with customers or agents for clarifications.
• Meet or exceed department production and quality standards and stay current with policies.

Skills

Customer service

Audits

Process improvement

Regulatory knowledge

Cross-functional collaboration

Education

High School diploma or GED

Tools

Enrollment systems

Billing systems

CRM software

Job description

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to handle enrollment, eligibility, and billing changes with high attention to accuracy and timeliness. The role requires strong customer service, auditing skills, and the ability to work with internal teams and external customers.

The position supports operations during a 7:00 AM to 5:00 PM PT window with a rotating late shift. Hybrid on-site work is available, with on-campus resources and training opportunities to