Remote Enrollment Quality & Compliance Specialist

Premera Blue Cross; Idaho Falls (ID); Remote; USD 42,000 - 71,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

Tuition assistance

401K and pension plan

Commuter perks

On-site parking (where available)

Job summary

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to manage complex enrollment, eligibility, billing changes, and audits with strong customer service. You will coordinate across teams, ensure regulatory compliance, and support strategic partners.

The role emphasizes audit development, process improvements, and education for agents and members, with shift coverage from early morning to late shift as needed.

Qualifications

• High School diploma or GED.
• Minimum of two (2) years of accounting/finance/bookkeeping experience or two (2) years enrollment processing experience.
• Associate’s degree in accounting.
• 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/partners by researching issues related to processing and applications.
• Research complex system issues impacting member eligibility and determine actions.
• Conduct performance audits to ensure transaction accuracy and identify improvements.
• Represent department on cross-functional teams and meet with external customers as required.
• Educate agents and members on membership and billing processes; assist with Web portal usage and policy interpretation.
• Provide back-up support across Enrollment & Billing and complete special projects.
• Track audit findings and ensure action plans are completed timely and accurately.

Skills

Customer service

Enrollment processing

Accounting/finance

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 complex enrollment, eligibility, billing changes, and audits with strong customer service. You will coordinate across teams, ensure regulatory compliance, and support strategic partners.

The role emphasizes audit development, process improvements, and education for agents and members, with shift coverage from early morning to late shift as needed.