Hybrid Enrollment Quality & Compliance Specialist

Premera Blue Cross; Athens (GA); Hybrid; USD 52,000 - 76,000; Full time

Benefits offered by this job

Medical, vision, and dental coverage

401K employer match

Tuition assistance

On-site parking

Hybrid/on-campus work model

On-site health & wellness center

Team engagement activities

Job summary

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to perform complex enrollment, eligibility, billing changes and reconciliations. You will research issues across systems, provide timely member support via phone, email, or written correspondence, and drive process improvements with partners.

You will participate in a late-shift rotation and support a 7:00 AM–5:00 PM PT window; hybrid on-campus opportunities are available.

Qualifications

• Two+ years in enrollment processing or accounting/finance experience.
• Strong customer service skills with ability to explain guidelines.
• Experience with audits, quality improvement, and regulatory knowledge.
• Collaborates with customers, partners and cross-functional teams.

Responsibilities

• Provides technical support to teams and implementation partners by researching and troubleshooting processing, system and software issues.
• Researches complex systems issues affecting member eligibility and determines course of action.
• Conducts performance audits to ensure compliance, accuracy and timeliness.
• Represents department on cross-functional teams and supports training materials.
• Tracks audit findings and follows up on action plans to completion.
• Updates eligibility, enrollment and billing of accounts.
• Educates agents and members on membership and billing processes.

Skills

Customer service

Audit & quality

System troubleshooting

Cross-functional work

Effective communication

Education

High School diploma or GED

Tools

Enrollment systems

Healthcare billing platforms

Job description

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to perform complex enrollment, eligibility, billing changes and reconciliations. You will research issues across systems, provide timely member support via phone, email, or written correspondence, and drive process improvements with partners.

You will participate in a late-shift rotation and support a 7:00 AM–5:00 PM PT window; hybrid on-campus opportunities are available.