Enrollment Quality & Compliance Specialist

Premera Blue Cross; Wisconsin; On-site; USD 28,000 - 39,000; Full time

Benefits offered by this job

Medical, vision, and dental coverage

Life and disability insurance

401K with employer match

Tuition assistance

Hybrid on-campus option

On-site parking

Well-being center

Job summary

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to handle enrollment, eligibility, billing changes, and account research. You will ensure accuracy, act as a resource for customers, and support audits and process improvements within our shift coverage model.

The role requires strong customer service, regulatory knowledge, and collaboration with internal and external partners to meet department standards and timelines.

Qualifications

• High School diploma or GED and at least two years in accounting/finance or enrollment processing.
• Experience conducting audits and improving quality and efficiency.
• Knowledge of healthcare regulations and administrative guidelines.
• Ability to collaborate with customers, partners, and cross-functional teams.

Responsibilities

• Provide technical support to teams by researching issues related to processing, systems, and software.
• Research complex systems issues affecting member eligibility and recommend actions.
• Participate in cross-functional meetings and training material updates for partner teams.
• Complete special projects and follow up on audit findings and action plans.
• Update enrollment, eligibility and billing records; communicate with customers and producers as needed.

Skills

Customer service

Audit & quality improvement

Enrollment processing knowledge

Regulatory guidelines knowledge

Cross-functional collaboration

Communication

Education

High School diploma or GED

Job description

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to handle enrollment, eligibility, billing changes, and account research. You will ensure accuracy, act as a resource for customers, and support audits and process improvements within our shift coverage model.

The role requires strong customer service, regulatory knowledge, and collaboration with internal and external partners to meet department standards and timelines.