Remote Enrollment Quality & Compliance Specialist

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

Benefits offered by this job

Medical, vision, and dental coverage

401K with company match

Wellness programs

Generous paid time off

Job summary

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to manage complex enrollment and billing changes with precision and compliance. You will support audits, assist strategic partners, and educate members and agents on regulatory guidelines.

You'll join a collaborative team supporting operations across Enrollment & Billing, with a telecommuter arrangement and opportunities to enhance efficiency and customer satisfaction while advancing healthcare administration expertise.

Qualifications

• High School diploma or GED is required.
• Two years of accounting/finance or enrollment processing experience.
• Associate’s degree in accounting is preferred.
• Previous customer service experience is preferred.
• Health or insurance industry experience is preferred.

Responsibilities

• Review plan provisions and apply enrollment rules in line with regulations.
• Provide technical support to teams and implementation partners.
• Research complex systems issues affecting member eligibility and advise on actions.
• Conduct performance audits to ensure compliance and identify improvements.
• Collaborate with cross-functional teams and external customers as needed.
• Educate agents and members on membership and billing processes.
• Assist with audits and ensure timely action on findings.

Skills

Accounting/finance experience

Enrollment processing experience

Customer service experience

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 and billing changes with precision and compliance. You will support audits, assist strategic partners, and educate members and agents on regulatory guidelines.

You'll join a collaborative team supporting operations across Enrollment & Billing, with a telecommuter arrangement and opportunities to enhance efficiency and customer satisfaction while advancing healthcare administration expertise.