Healthcare Enrollment & Quality Assurance Specialist

Premera Blue Cross; Heber (UT); Vor Ort; USD 50.000 - 70.000; Vollzeit

Benefits dieser Stelle

401k employer match

Pension plan after 3 years

Tuition assistance

On-site parking

Well-being center

On-site health events

Zusammenfassung

Premera Blue Cross in Utah seeks an Enrollment Oversight and Quality Specialist to perform enrollment, eligibility, billing changes, and reconciliation. You will handle audits, process improvements, and partner with internal teams and external customers via phone, email or written correspondence within set turnaround times.

The role requires strong customer service skills, knowledge of healthcare regulations, and ability to explain guidelines clearly.

Qualifikationen

• High School diploma or GED.
• 2+ years accounting/finance or enrollment processing experience.
• Previous customer service experience.
• Health or insurance industry experience.
• Expertise in complex enrollment, eligibility, billing, and reconciliation processes.

Aufgaben

• Provides technical support to assigned teams by researching and/or troubleshooting issues related to processing, system, and software applications.
• Researches complex system issues impacting member eligibility and determines appropriate actions; conducts performance audits for accuracy and timeliness.
• Represents department on cross-functional teams and meets with external customers as required.
• Reviews procedures and training materials to outline improvements for efficiency.
• Tracks audit findings and action plans to ensure timely completion.
• Update eligibility, enrollment and/or billing of accounts.
• Educate agents and members on membership and billing processes and rules.

Kenntnisse

Enrollment processing

Audit & quality

Customer service

Regulatory guidelines

Cross-functional collaboration

Ausbildung

High School diploma

Accounting/finance experience

Jobbeschreibung

Premera Blue Cross in Utah seeks an Enrollment Oversight and Quality Specialist to perform enrollment, eligibility, billing changes, and reconciliation. You will handle audits, process improvements, and partner with internal teams and external customers via phone, email or written correspondence within set turnaround times.

The role requires strong customer service skills, knowledge of healthcare regulations, and ability to explain guidelines clearly.