Enrollment Oversight & Quality Specialist (Healthcare)

Location: Telecommuter within one of the listed US states: Alaska, Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Iowa, Kansas, Kentucky, Maine, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington, or Wisconsin. Availability is required during the 7:00 AM–5:00 PM PT coverage window, with a late-shift rotation typically one day per week.

Salary: $41,500–$62,300 national range; $47,400–$71,100 national plus range for higher-cost labor markets including Western Washington and Alaska.

Company

hirify.global improves healthcare access and service for members, customers, and communities through health insurance solutions.

What you will do

• Review plan provisions and apply contractual, state, and federal rules to individual and group enrollment scenarios.
• Process complex enrollment, eligibility, billing, plan changes, dependent additions, transfers, and account reconciliations.
• Research and troubleshoot system, software, eligibility, and billing issues for customers, agents, internal teams, and implementation partners.
• Conduct performance audits, track findings and action plans, and implement process improvements.
• Explain enrollment, billing, membership, portal, and regulatory requirements through phone, email, and written correspondence.
• Represent Enrollment and Billing on cross-functional teams and support training materials, peak-load work, and special projects.

Requirements

• High school diploma or GED required.
• At least two years of accounting, finance, bookkeeping, or enrollment processing experience required.
• Ability to meet production and quality standards and follow company and department procedures.
• Availability during the 7:00 AM–5:00 PM PT coverage window and participation in a recurring late-shift rotation.
• Ability to communicate clearly by telephone and in writing and perform primarily sedentary computer-based work.

Nice to have

• Associate degree in accounting.
• Previous customer service experience.
• Health or insurance industry experience.

Culture & Benefits

• Medical, vision, and dental coverage with low employee premiums.
• Life and disability insurance, retirement programs with a 401(k) match, and a pension plan vested after three years.
• Paid time off, wellness resources, counseling, stress management, and mindfulness programs.
• Tuition assistance for undergraduate and graduate education.
• Employee recognition programs and additional voluntary benefits, including pet insurance.