Enrollment Quality & Compliance Specialist

Premera Blue Cross; Wisconsin; On-site; USD 45,000 - 65,000; Full time

Benefits offered by this job

Health insurance

401K + pension

Tuition assistance

Hybrid on-campus work

Free on-site parking

Wellness center

On-site activities

Health and wellbeing programs

Job summary

Premera Blue Cross seeks an Enrollment Oversight and Quality Specialist to manage complex enrollment, eligibility and billing changes across systems, delivering exceptional service to members and agents.

The role includes audits, process improvements, cross-functional collaboration, and education of customers on enrollment rules, with early and late shift coverage to support operations.

Qualifications

• Two years accounting/finance or enrollment processing experience.
• Exceptional customer service and communication skills.
• Experience conducting audits and process improvements.
• Knowledge of healthcare regulations and enrollment rules.

Responsibilities

• Provide technical support to teams and partners by researching issues with processing, systems and software.
• Research complex enrollment issues and determine appropriate actions; conduct performance audits.
• Represent department on cross-functional teams and engage external customers as needed.
• Update training materials and outline improvements for efficiency.
• Complete special projects and track audit findings and action plans.
• Update eligibility, enrollment and billing records; educate agents and members on enrollment rules.

Skills

Customer service

Audits

Process improvement

Cross-functional

Education

High School diploma or GED

Accounting/finance experience

Enrollment processing experience

Job description

Premera Blue Cross seeks an Enrollment Oversight and Quality Specialist to manage complex enrollment, eligibility and billing changes across systems, delivering exceptional service to members and agents.

The role includes audits, process improvements, cross-functional collaboration, and education of customers on enrollment rules, with early and late shift coverage to support operations.