Enrollment Quality & Compliance Specialist - Hybrid

Premera Blue Cross; Sioux Falls (SD); Sur place; USD 50 000 - 70 000; Plein temps

Avantages offerts par ce poste

Health insurance

Retirement plan

On-site parking

Wellness center

Résumé du poste

Premera Blue Cross in Sioux Falls, SD is seeking an Enrollment Oversight and Quality Specialist to handle enrollment, eligibility, billing changes and audits with strong customer service. You will support internal and external customers via phone, email or written correspondence, explaining guidelines and offering alternatives as needed.

The role includes participating in late shifts, cross-functional collaboration, and maintaining training materials to improve efficiency and accuracy in

Qualifications

• High School diploma or GED required; 2 years of accounting/finance/bookkeeping or enrollment processing experience preferred.
• Experience in health or insurance enrollment, eligibility, billing and reconciliation processes.
• Strong customer service skills and ability to explain administrative guidelines clearly.

Responsabilités

• Perform enrollment, eligibility, billing changes and reconciliation tasks.
• Research and resolve complex enrollment and billing issues for members and agents.
• Conduct audits and implement process improvements in collaboration with partners.
• Educate agents and members on membership and billing rules and portal usage.
• Support strategic partners with training material and performance tracking.
• Complete special projects and ensure timely action on audit findings.

Connaissances

Customer service

Enrollment processing

Billing and reconciliation

Complex systems

Formation

High School diploma or GED

Outils

Web portal usage

Regulation interpretation

Description du poste

Premera Blue Cross in Sioux Falls, SD is seeking an Enrollment Oversight and Quality Specialist to handle enrollment, eligibility, billing changes and audits with strong customer service. You will support internal and external customers via phone, email or written correspondence, explaining guidelines and offering alternatives as needed.

The role includes participating in late shifts, cross-functional collaboration, and maintaining training materials to improve efficiency and accuracy in