Remote Enrollment Quality & Compliance Specialist

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

Benefits offered by this job

On-site parking

Commuter perks

Tuition assistance

Well-being center

Job summary

Premera Blue Cross in the United States is seeking an Enrollment Oversight and Quality Specialist to manage complex enrollment, eligibility, billing changes, and coordination of audits. You will support internal teams and strategic partners, ensuring regulatory compliance and timely communication with members and agents.

This role emphasizes meticulous audits, process improvements, and education of agents and members on enrollment and billing procedures.

Qualifications

• High School diploma or GED. (Required)
• Minimum of two (2) years of accounting/finance/bookkeeping experience or two (2) years enrollment processing experience. (Required)
• Associate’s degree in accounting. (Preferred)
• Previous customer service experience. (Preferred)
• Health or insurance industry experience. (Preferred)

Responsibilities

• Review plan provisions and apply rules for enrollment scenarios. Ensure compliance with regulations.
• Provide technical support to teams and implementation partners for issues related to processing and applications.
• Research complex systems issues impacting member eligibility and advise on actions.
• Conduct performance audits to ensure transactions are accurate and timely and suggest improvements.
• Represent the department on cross-functional teams and meet with external customers as required.
• Update training materials and outline improvements with training and quality teams.

Skills

Enrollment processing

Customer service

Accounting/finance

Education

High school diploma

Associate’s degree in accounting

Job description

Premera Blue Cross in the United States is seeking an Enrollment Oversight and Quality Specialist to manage complex enrollment, eligibility, billing changes, and coordination of audits. You will support internal teams and strategic partners, ensuring regulatory compliance and timely communication with members and agents.

This role emphasizes meticulous audits, process improvements, and education of agents and members on enrollment and billing procedures.