Remote Enrollment Quality & Compliance Specialist

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

Benefits offered by this job

Commuter perks

Free on-site parking

Tuition assistance

Job summary

Premera Blue Cross is seeking an Enrollment Oversight Specialist to support enrollment, eligibility, billing changes, and audits from a telecommuter role. You will work with internal and external customers by phone, email, or written correspondence, ensuring compliance with federal and state guidelines while contributing to process improvements.

This role requires strong customer service skills and experience in enrollment processing or accounting, with potential for professional growth in

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.
• Provide technical support to assigned teams and implementation partners.
• Research complex systems issues impacting member eligibility and determine actions.
• Conduct performance audits to ensure transaction compliance and identify improvements.
• Represent department on cross-functional teams and meet with external customers as required.
• Update training materials and outline improvements for efficiency.
• Provide backup and peak-load assistance across Enrollment & Billing as needed; complete special projects.
• Track audit findings and ensure action plans are completed on time.
• Process plan changes, dependent add-ons, direct transfers, and complex enrollments.
• Contact customers or producers for enrollment clarification and guidance.

Skills

Enrollment processing

Customer service

Education

High School diploma or GED

Associate’s degree in accounting

Job description

Premera Blue Cross is seeking an Enrollment Oversight Specialist to support enrollment, eligibility, billing changes, and audits from a telecommuter role. You will work with internal and external customers by phone, email, or written correspondence, ensuring compliance with federal and state guidelines while contributing to process improvements.

This role requires strong customer service skills and experience in enrollment processing or accounting, with potential for professional growth in