Remote Enrollment & Quality Assurance Specialist

Premera Blue Cross; Montana City (MT); Remote; USD 42,000 - 62,000; Full time

Benefits offered by this job

Commuter perks

On-site parking

On-campus cafes

Well-being center

Job summary

Premera Blue Cross is hiring an Enrollment Oversight and Quality Specialist in a telecommuter role. You will review enrollment rules, research issues, conduct audits, and collaborate with internal teams to improve processes and compliance.

You will support customers and producers, educate on enrollment and billing guidelines, and handle complex administrative tasks across multiple systems. This remote role offers hybrid benefits and pays within the national salary range.

Qualifications

• High School diploma or GED is required.
• Two years accounting/finance experience 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 enrollment rules per state and federal guidelines.
• Provide technical support to teams/partners for processing issues.
• Research complex systems issues affecting member eligibility and determine actions.
• Conduct performance audits for compliance, accuracy and timeliness.
• Represent the department on cross-functional teams and coordinate with partners.
• Update training materials with partners to improve efficiency.
• Provide back-up support across Enrollment & Billing and handle special projects.
• Track audit findings and ensure action plans are completed promptly.
• Process plan changes, dependent add-ons, transfers and complex enrollments.
• Contact customers or producers for clarification and guidance on regulatory issues.
• Meet or exceed production and quality standards; stay current on policies.

Skills

Customer service

Education

High School diploma or GED

Associate’s degree in accounting

Job description

Premera Blue Cross is hiring an Enrollment Oversight and Quality Specialist in a telecommuter role. You will review enrollment rules, research issues, conduct audits, and collaborate with internal teams to improve processes and compliance.

You will support customers and producers, educate on enrollment and billing guidelines, and handle complex administrative tasks across multiple systems. This remote role offers hybrid benefits and pays within the national salary range.