Remote Enrollment Quality & Compliance Specialist

Premera Blue Cross; Clifton (TX); Remote; USD 42,000 - 62,000; Full time

Benefits offered by this job

Medical, vision, and dental coverage

401K retirement plan with employer-mey

Paid time off

On-site parking

Job summary

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to manage enrollment, eligibility, billing changes, and audit processes across internal and external customers. You will apply state and federal guidelines and support strategic partners with issue resolution.

The role requires strong customer service and knowledge of enrollment procedures, with opportunities to contribute to process improvements and training within Enrollment & Billing teams.

Qualifications

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

Responsibilities

• Review enrollment provisions and apply applicable rules for enrollment scenarios.
• Provide technical support to teams by researching issues related to processing and systems.
• Research complex systems issues affecting member eligibility and advise actions.
• Conduct performance audits to improve transaction accuracy and timeliness.
• Collaborate with cross-functional teams and external customers as needed.
• Assist in training material reviews and partner training for efficiency.

Skills

Customer service

Attention to detail

Communication

Problem solving

Education

High School diploma or GED

Associate’s degree in accounting

Job description

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to manage enrollment, eligibility, billing changes, and audit processes across internal and external customers. You will apply state and federal guidelines and support strategic partners with issue resolution.

The role requires strong customer service and knowledge of enrollment procedures, with opportunities to contribute to process improvements and training within Enrollment & Billing teams.