Remote Enrollment Quality & Audit Specialist

Premera Blue Cross; Florida; Remote; USD 42,000 - 62,000; Full time

Benefits offered by this job

Commuter perks

Free on-site parking

Tuition assistance

Wellness programs

Job summary

Premera Blue Cross seeks an Enrollment Oversight and Quality Specialist to perform complex enrollment, eligibility, billing changes, and account research using multiple systems. The role emphasizes exceptional customer service with internal and external customers via phone, email, or written correspondence within department timelines.

It supports audits, procedures, and partner-driven improvements. The position requires availability across a 7:00 AM–5:00 PM PT window with late-shift rotations,

Qualifications

• High School diploma or GED (Required).
• Minimum of two (2) years of accounting/finance/bookkeeping experience or two (2) years enrollment processing experience (Required).
• Associate’s degree in accounting (Preferred).
• Previous customer service experience (Preferred).
• Health or insurance industry experience (Preferred).

Responsibilities

• Review plan provisions and apply rules for enrollment scenarios, ensuring compliance with contracts, state and federal guidelines.
• Provide technical support to teams by researching and troubleshooting issues with processing, systems and software.
• Investigate member eligibility issues and determine appropriate actions, escalating as needed.
• Conduct performance audits to ensure transaction accuracy and timeliness; identify and implement improvements.
• Participate in cross-functional teams and engage with external customers as required.
• Review training materials and partner training to improve efficiency and accuracy.
• Provide back-up and peak-load assistance across Enrollment & Billing as needed; handle special projects.
• Track audit findings and coordinate action plans with partners to ensure completion.

Skills

Customer service

Communication

Problem solving

Attention to detail

Education

High School diploma or GED

Associate’s degree in accounting

Job description

Premera Blue Cross seeks an Enrollment Oversight and Quality Specialist to perform complex enrollment, eligibility, billing changes, and account research using multiple systems. The role emphasizes exceptional customer service with internal and external customers via phone, email, or written correspondence within department timelines.

It supports audits, procedures, and partner-driven improvements. The position requires availability across a 7:00 AM–5:00 PM PT window with late-shift rotations,