Remote Enrollment Quality & Compliance Specialist

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

Job summary

Premera Blue Cross is hiring an Enrollment Oversight and Quality Specialist in a telecommuter role to manage enrollment, eligibility, billing changes, and account research with strong customer service via phone, email or written correspondence within department timelines.

The position supports audits, procedures, and efficiency improvements and collaborates with internal and external partners to meet regulatory guidelines and ensure accurate processing.

Qualifications

• High School diploma or GED is required.
• At least 2 years of accounting/finance or enrollment processing experience.
• Associate’s degree in accounting preferred.
• Customer service experience preferred.
• Health or insurance industry experience preferred.

Responsibilities

• Review plan provisions and apply rules for enrollment scenarios.
• Provide technical support to teams and implementation partners.
• Research complex systems issues impacting member eligibility.
• Conduct performance audits to ensure compliance and improve processes.
• Educate agents and members on membership and billing processes.

Skills

Accounting/Finance

Enrollment processing

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 to manage enrollment, eligibility, billing changes, and account research with strong customer service via phone, email or written correspondence within department timelines.

The position supports audits, procedures, and efficiency improvements and collaborates with internal and external partners to meet regulatory guidelines and ensure accurate processing.