Remote Enrollment Quality & Audit Specialist

Premera Blue Cross; Lexington (KY); Remote; USD 52,000 - 76,000; Full time

Job summary

Premera Blue Cross is hiring an Enrollment Oversight and Quality Specialist to handle enrollment, eligibility, and billing changes with a focus on accuracy and regulatory compliance. You will support internal teams and external customers via phone, email, or written correspondence within established turnaround times.

The role requires strong customer service skills, the ability to explain administrative guidelines clearly, and participation in occasional late-shift rotations to support business

Qualifications

• Minimum of two years of accounting/finance/bookkeeping experience or enrollment processing experience.
• Associate’s degree in accounting required.
• Strong customer service skills and ability to explain complex information clearly.

Responsibilities

• Review plan provisions and apply rules for Individual or Group enrollment scenarios in compliance with regulations.
• Provide technical support to teams and implementation partners for processing and system issues.
• Research complex systems issues affecting member eligibility and determine appropriate actions.
• Conduct performance audits to ensure transaction accuracy and timeliness and identify process improvements.
• Educate agents and members on billing processes and administrative rules.

Skills

Customer service

Communication

Attention to detail

Education

Associate’s degree in accounting

Tools

Accounting software

Job description

Premera Blue Cross is hiring an Enrollment Oversight and Quality Specialist to handle enrollment, eligibility, and billing changes with a focus on accuracy and regulatory compliance. You will support internal teams and external customers via phone, email, or written correspondence within established turnaround times.

The role requires strong customer service skills, the ability to explain administrative guidelines clearly, and participation in occasional late-shift rotations to support business