Remote Enrollment Quality Specialist

Premera Blue Cross; Lorida (FL); Remote; USD 42.000 - 62.000; Vollzeit

Benefits dieser Stelle

Medical, vision, and dental coverage

401K matching

Tuition assistance

Wellness programs

Zusammenfassung

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to review plan provisions, apply enrollment rules, and perform audits to improve accuracy and efficiency. You’ll collaborate with internal teams and strategic partners to ensure compliance and timely processing.

This telecommuter role requires 2+ years in accounting/finance or enrollment processing, plus customer service experience; health/insurance experience is a plus.

Qualifikationen

• 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)

Aufgaben

• Review plan provisions and apply enrollment rules for Individual or Group enrollment scenarios.
• Provide technical support to teams/partners by researching issues in processing, systems, and software applications.
• Serve as a resource for customers by researching complex eligibility issues and determining actions.
• Conduct performance audits to ensure transaction accuracy and timeliness; identify improvements.
• Represent department on cross-functional teams and meet external customers as required.
• Review training material and outline improvements for efficiency with training teams.
• Provide back-up and peak-load assistance across Enrollment & Billing as needed.
• Track audit findings and action plans to ensure timely completion.
• Process plan changes, dependent add-ons, direct transfers, and challenging enrollments.
• Contact customers or producers for enrollment clarification and guidance on guidelines.
• Meet or exceed department production and quality standards; stay current on policies.
• Educate agents and members on membership and billing processes; may include Web portal usage.
• Perform other duties as assigned.

Kenntnisse

Accounting/Finance

Enrollment processing

Customer service

Ausbildung

High School diploma or GED

Associate’s degree in accounting

Jobbeschreibung

Premera Blue Cross is seeking an Enrollment Oversight and Quality Specialist to review plan provisions, apply enrollment rules, and perform audits to improve accuracy and efficiency. You’ll collaborate with internal teams and strategic partners to ensure compliance and timely processing.

This telecommuter role requires 2+ years in accounting/finance or enrollment processing, plus customer service experience; health/insurance experience is a plus.