Eligibility & Member Services Specialist — Workforce Benefits

Pacific Life; Omaha (NE); On-site; USD 3,611,000 - 4,429,000; Full time

Benefits offered by this job

Medical, Dental, Vision

Wellbeing Reimbursement Account

Generous paid time off

Paid Parental Leave

Adoption Assistance Program

401k with company match

Job summary

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

The role emphasizes data accuracy, end-to-end impact of policy and rate changes, and building trusted advisor relationships with Sales, Distribution, and Underwriting.

Qualifications

• College degree or equivalent experience preferred.
• 3-5 years of financial services, product compliance or group benefits operations experience
• Effective communicator with externally facing presence
• Customer-centric with problem-solving skillset
• Detail-oriented
• Strong analytical skills
• Demonstrated time management and organizational skills
• Intermediate skills with MS office applications

Responsibilities

• Research and remediate inforce client challenges related to member management.
• Identify root causes of complex member level discrepancies by researching plan design, rates, file feed data and comparing to Administration System and TPA information.
• Understand end to end impact of policy, rate, and member level changes to eligibility and billing.
• Identify needed changes to update member level data and coordinate file feeds for data accuracy.
• Leverage data from multiple sources and use tools and formulas for large comparisons.
• Determine back charges or credits that need reviewed and discuss with Underwriting, Billing and Distribution.
• Consult with clients and make decisions aligned with our operating model to resolve issues.
• Build strong relationships with Sales/Distribution, Brokers and Employers as a trusted advisor.
• Coordinate, manage and lead conversations with Employers, Brokers and other partners for exceptional customer experience.
• Own issues to ensure timely resolution and escalate to management with recommendations.
• Follow-up and provide transparent communications on status of outstanding issues.
• Understand the full Broker, Employer, and Employee journey to deliver elevated service.
• Work within departmental controls with a high standard of ethics.
• Know product offering, systems, and processes and data flows across journeys.
• Participate in team meetings and bring innovative ideas for continuous improvement

Skills

Effective communicator

Customer-centric

Detail oriented

Analytical skills

Time management

MS Office

Education

Bachelor's degree preferred

Tools

EIS System

Excel

MS Office

Job description

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

The role emphasizes data accuracy, end-to-end impact of policy and rate changes, and building trusted advisor relationships with Sales, Distribution, and Underwriting.