Remote Enrollment Quality & Compliance Specialist

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

Benefits offered by this job

Medical, vision, and dental coverage

401(k) employer match

Tuition assistance

Job summary

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to manage moderate to complex enrollment, eligibility, and billing changes. The role emphasizes customer service, regulatory guidance, and audit-related responsibilities within a telecommuter work model.

Candidates should be prepared to support operations during a 7:00 AM to 5:00 PM PT window, with a late-shift rotation. Experience in health or insurance is preferred, supporting a dynamic, compliant enrollment

Qualifications

• High School diploma or GED is required.
• Minimum of two years of accounting/finance/bookkeeping experience or enrollment processing experience is required.
• 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 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 efficiency.
• Represent department on cross-functional teams with external customers.
• Update training materials and implement improvements for efficiency.
• Provide back-up support across Enrollment & Billing as needed.

Skills

Customer service

Accounting

Billing

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 moderate to complex enrollment, eligibility, and billing changes. The role emphasizes customer service, regulatory guidance, and audit-related responsibilities within a telecommuter work model.

Candidates should be prepared to support operations during a 7:00 AM to 5:00 PM PT window, with a late-shift rotation. Experience in health or insurance is preferred, supporting a dynamic, compliant enrollment