Remote Enrollment Quality & Compliance Specialist

Premera Blue Cross; United States; Remote; USD 42,000 - 71,000; Full time

Job summary

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to handle complex enrollment, eligibility, billing changes, and reconciliation across systems. The role emphasizes exceptional customer service for members and agents via phone, email, or written correspondence within tight timelines.

Responsibilities include auditing processes, updating audits and procedures, and supporting strategic partners.

Qualifications

• Enrollment processing knowledge and ability to apply rules per enrollment scenarios.
• Auditing and quality improvement experience or interest preferred.
• Customer service experience with internal and external customers.

Responsibilities

• Review plan provisions and apply rules for enrollment scenarios.
• Provide technical support to teams and implementation partners.
• Research complex eligibility issues and determine appropriate actions.

Skills

Enrollment processing

Customer service

Audit support

Education

High School diploma or GED

Associate’s degree in accounting

Two years enrollment processing experience

Two years accounting/finance/bookkeeping experience

Health or insurance industry experience

Previous customer service experience

Job description

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to handle complex enrollment, eligibility, billing changes, and reconciliation across systems. The role emphasizes exceptional customer service for members and agents via phone, email, or written correspondence within tight timelines.

Responsibilities include auditing processes, updating audits and procedures, and supporting strategic partners.