Remote Enrollment Quality & Compliance Specialist

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

Job summary

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist (telecommuter) to support enrollment, eligibility, billing changes, and audits. The role requires strong customer service, regulatory knowledge, and ability to research complex issues across systems.

Candidates will help improve audit processes and coordinate with implementation partners. Typical day includes reviewing plan provisions, applying guidelines, and providing guidance to members and agents.

Qualifications

• High School diploma or GED required.
• 2+ years of accounting/finance or enrollment processing experience required.
• Associates degree in accounting preferred.
• Health or insurance industry experience preferred.

Responsibilities

• Review plan provisions and apply enrollment rules per contract, state, and federal guidelines.
• Provide technical support to teams by researching issues related to processing systems and software.
• Research complex system issues affecting member eligibility and advise on actions.
• Conduct performance audits to ensure accuracy and timeliness; identify process improvements.
• Educate agents and members on enrollment and billing processes; assist with regulations.
• Handle back-up support across Enrollment & Billing and assist with special projects.

Skills

Customer service

Audits

Problem solving

Research

Regulatory knowledge

Education

High School diploma or GED

Associate’s degree in accounting

Job description

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist (telecommuter) to support enrollment, eligibility, billing changes, and audits. The role requires strong customer service, regulatory knowledge, and ability to research complex issues across systems.

Candidates will help improve audit processes and coordinate with implementation partners. Typical day includes reviewing plan provisions, applying guidelines, and providing guidance to members and agents.