Eligibility & Member Services Specialist – Workforce

pacificlife; Omaha (NE); On-site; USD 55,000 - 67,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Wellbeing reimbursement account

PTO and holidays

Financial planning time off

Paid parental leave

Job summary

Pacific Life in Omaha, NE is seeking an Eligibility & Member Services Specialist to join the Employer Services Team. You will audit and resolve discrepancies in member data, partner with brokers and employers, and deliver a friction-free experience in the Workforce Benefits Division.

You will work on a team of 15 and collaborate with Eligibility, Account Executives, and Billing professionals. Strong communication, analytics, and data-management skills are essential.

Qualifications

• College degree or equivalent experience preferred.
• 3-5 years of financial services, product compliance or group benefits operations experience.
• Effective communicator with external stakeholders.
• Customer-centric with problem-solving skillset.
• Detail-oriented with strong analytics.
• Demonstrated time management and organizational skills.
• Intermediate MS Office applications.

Responsibilities

• Research, problem-solve and remediate inforce client challenges related to member management.
• Identify root causes of discrepancies by researching plan design, rates, file feeds and comparing to Administration System and TPA data.
• Understand end-to-end impact of policy, rate and member-level changes to eligibility and billing.
• Update member-level data and coordinate file feeds to ensure system data accuracy.
• Leverage data from multiple sources and use formulas for large comparisons.
• Negotiate on due amounts with Underwriting, Billing and Distribution when needed.
• Consult with clients to resolve issues and provide transparent status updates.

Skills

Client communication

Analytical thinking

Attention to detail

Time management

Problem solving

Education

College degree or equivalent experience

Tools

Excel

EIS System

Job description

Pacific Life in Omaha, NE is seeking an Eligibility & Member Services Specialist to join the Employer Services Team. You will audit and resolve discrepancies in member data, partner with brokers and employers, and deliver a friction-free experience in the Workforce Benefits Division.

You will work on a team of 15 and collaborate with Eligibility, Account Executives, and Billing professionals. Strong communication, analytics, and data-management skills are essential.