Remote Enrollment Quality & Compliance Specialist

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

Benefits offered by this job

Medical, vision, dental coverage

401K employer match with pension plan

On-site parking and commuter perks

Tuition assistance

Job summary

Premera Blue Cross is hiring for an Enrollment Oversight and Quality Specialist. The role requires handling moderate to complex enrollment, eligibility, billing changes, reconciliations, and audit processes with a focus on regulatory guidelines and quality outcomes.

You will support internal teams and strategic partners, research issues, and provide guidance to customers and agents. The position includes peak-load support and participation in a late-shift rotation as needed.

Qualifications

• High School diploma or GED required
• Minimum of two years of accounting/finance, bookkeeping, or enrollment processing experience
• Associate degree in accounting preferred
• Previous customer service experience preferred
• Health or insurance industry experience preferred

Responsibilities

• Review plan provisions and apply rules for Individual or Group enrollment scenarios
• Provide technical support to teams and implementation partners
• Research complex systems issues impacting member eligibility and determine action
• Conduct performance audits to ensure transaction accuracy and timeliness
• Represent department on cross-functional teams with external customers
• Review procedures and training materials to improve efficiency
• Provide back-up support across Enrollment & Billing and complete special projects
• Track audit findings and ensure action plans are completed timely
• Process plan changes, add-ons, transfers, and complex enrollments
• Communicate with customers or producers for enrollment clarification

Skills

Customer service

Enrollment processing

Auditing

Education

Associate degree in accounting

High School diploma or GED

Job description

Premera Blue Cross is hiring for an Enrollment Oversight and Quality Specialist. The role requires handling moderate to complex enrollment, eligibility, billing changes, reconciliations, and audit processes with a focus on regulatory guidelines and quality outcomes.

You will support internal teams and strategic partners, research issues, and provide guidance to customers and agents. The position includes peak-load support and participation in a late-shift rotation as needed.