Healthcare Enrollment Quality Specialist

Premera Blue Cross; South Dakota; Hybride; USD 55 000 - 85 000; Plein temps

Avantages offerts par ce poste

Medical, vision, dental insurance

401(k) with company match

Pension plan

Tuition assistance

On-site parking

Fitness & well-being center

Team engagement events

Résumé du poste

Premera Blue Cross seeks an Enrollment Oversight and Quality Specialist to handle complex enrollment, eligibility, billing changes and reconciliation. You will research accounts, respond to members and agents, and support audits and efficiency improvements with internal teams and partners.

The role requires strong customer service, knowledge of healthcare regulations, and collaboration with cross-functional teams to ensure accurate processing and timely responses.

Qualifications

• Minimum of two years accounting, finance, or enrollment processing experience.
• Experience with audits, quality improvements, and regulatory guidelines.
• Health or insurance industry experience is preferred.

Responsabilités

• Perform enrollment, eligibility, billing changes and reconciliations.
• Research accounts and respond to members/agents with guidance on guidelines.
• Support audits, procedures, and efficiency initiatives with partners.
• Update enrollment and billing records and communicate with customers.
• Educate agents and members on membership and billing processes.

Connaissances

Accounting basics

Enrollment processing

Customer service

Healthcare/insurance knowledge

Formation

High School diploma or GED

Description du poste

Premera Blue Cross seeks an Enrollment Oversight and Quality Specialist to handle complex enrollment, eligibility, billing changes and reconciliation. You will research accounts, respond to members and agents, and support audits and efficiency improvements with internal teams and partners.

The role requires strong customer service, knowledge of healthcare regulations, and collaboration with cross-functional teams to ensure accurate processing and timely responses.