Remote Enrollment Quality & Compliance Specialist

Premera Blue Cross; Yuma (AZ); Remote; USD 42,000 - 62,000; Full time

Benefits offered by this job

Medical, vision, and dental coverage

Life and disability insurance

Retirement programs including 401K and

Tuition assistance for undergraduate &

Job summary

Premera Blue Cross is hiring an Enrollment Oversight and Quality Specialist to manage complex enrollment, eligibility, billing changes and reconciliation across internal and external customers. You will support audits, research issues, and coordinate improvements with strategic partners.

The role requires strong customer service, knowledge of administrative guidelines, and the ability to work within 7:00 AM–5:00 PM PT window with occasional late shift rotations.

Qualifications

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

Responsibilities

• Review plan provisions and apply rules for enrollment scenarios.
• Provide technical support to teams and implementation partners.
• Research complex systems issues affecting eligibility and determine actions.
• Conduct performance audits to ensure compliance and improve processes.
• Collaborate with cross-functional teams and external customers as needed.
• Review training materials and outline improvements for efficiency.
• Provide back-up support across Enrollment & Billing as needed and handle special projects.
• Track audit findings and ensure timely action plans and responses.

Skills

Enrollment processing

Customer service

Education

High School diploma or GED

Associate’s degree in accounting

Job description

Premera Blue Cross is hiring an Enrollment Oversight and Quality Specialist to manage complex enrollment, eligibility, billing changes and reconciliation across internal and external customers. You will support audits, research issues, and coordinate improvements with strategic partners.

The role requires strong customer service, knowledge of administrative guidelines, and the ability to work within 7:00 AM–5:00 PM PT window with occasional late shift rotations.