Remote Enrollment Oversight & Quality Specialist

Premera Blue Cross; Clayton (MO); Remote; USD 42,000 - 62,000; Full time

Benefits offered by this job

Medical, vision, and dental coverage

401K employer match

Paid time off

Tuition assistance

Job summary

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to handle moderate to complex enrollment, eligibility, billing changes, and audits. The role supports internal and external customers via phone, email, or written correspondence within department timelines.

Night and early shifts may be required as part of a late-shift rotation. The position emphasizes accuracy, regulatory knowledge, and collaboration with strategic implementation partners to improve audits and

Qualifications

• High School diploma or GED required.
• Two years accounting/finance or enrollment processing experience required.
• Associate’s degree in accounting preferred.
• Customer service experience preferred.
• Health or insurance industry experience preferred.

Responsibilities

• Review plan provisions and apply federal, state, and contractual guidelines for enrollment scenarios.
• Provide technical support to teams and implementation partners on processing issues.
• Research complex system issues impacting member eligibility and escalate as needed.
• Conduct performance audits to ensure compliance and identify process improvements.
• Collaborate with cross-functional teams and external customers as required.
• Maintain training materials and assist partner training for efficiency improvements.
• Provide back-up support across Enrollment & Billing and complete special projects.

Skills

Customer service

Enrollment processing

Accounting/finance

Education

High school diploma or GED

Associate’s degree in accounting

Job description

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to handle moderate to complex enrollment, eligibility, billing changes, and audits. The role supports internal and external customers via phone, email, or written correspondence within department timelines.

Night and early shifts may be required as part of a late-shift rotation. The position emphasizes accuracy, regulatory knowledge, and collaboration with strategic implementation partners to improve audits and