Group Processing Specialist II

PacificSource; Portland (OR); Hybrid; USD 36,000 - 57,000; Full time

Benefits offered by this job

Flexible telecommute policy

Medical insurance

Vision and dental insurance

401(k) plan

Paid time off and holidays

Tuition reimbursement and training

Job summary

PacificSource in Portland, OR is seeking a Group Processing professional to manage new group setup, renewals, and changes for insured, self-funded and student health plans. You will prepare plan materials and ID cards while ensuring accuracy and timelines.

The role requires at least 2 years of health insurance experience, strong Excel and communication skills, and ability to coordinate with Actuarial, Underwriting, and other teams.

Qualifications

• High school diploma or equivalent required.
• Minimum 2 years of related medical insurance or healthcare experience.
• Strong Excel skills and effective written/spoken communication.
• Ability to interpret state and federal insurance regulations and PacificSource procedures.

Responsibilities

• Process new group materials, renewals, and change requests for insured and self-funded groups.
• Enter group data into the Online Enrollment System and the Online Waiver System.
• Validate product and financial codes and coordinate with Actuarial and Underwriting.
• Prepare plan materials and ID cards with accuracy and on schedule.
• Track processing status and maintain group notes.

Skills

Excel

Typing

Communication

Problem Solving

Teamwork

Education

High school diploma or equivalent

Tools

Facets

Online Enrollment System

Online Waiver System

Job description

Introduction

Looking for a way to make an impact and help people? Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths.

Role Overview

Responsible for processing new small and large group setup, renewals, and change requests. Prepare plan materials and ID cards while maintaining entry accuracy and timeline requirements. Ensure compliance with organizational policies, procedures, and relevant legal and regulatory standards.

Essential Responsibilities

• Process new group materials, change requests, member applications, and renewals for small and large fully insured groups, self-funded groups, and student health plans.
• Coordinate and confirm custom benefits and eligibility variations as required.
• Coordinate with teams to review and create new products or plan materials, as needed.
• Attend new and renewing large group implementation meetings.
• Identify customization, testing needs, and timelines for deliverables.
• Review group master applications, renewal confirmation forms, proposal requests, and various other forms or correspondence received.
• Follow up with internal teams for missing information.
• Analyze new and renewing group structure, billing, and reporting requirements.
• Enter group data into various applications including the Online Enrollment System and the Online Waiver System.
• Validate product codes, financial codes, and other related codes for groups and subgroups.
• Coordinate with Facets Business Support team for new product implementations as needed.
• Create and distribute plan materials accurately and timely.
• Process all group demographic changes.
• Generate census and cross-reference member information on master application with final proposal census.
• Process final premium rates for new group enrollments and group renewals.
• Coordinate with Actuarial and Underwriting teams as needed.
• Track group processing status and maintain group notes.
• Verify appointed producer and enter data into the appropriate system.
• Provide essential QA testing of new processes or updates in Facets and other systems as needed.
• Assist with Commercial Individual and Government product line group configurations, as necessary.
• Update and maintain the team escalation board.
• Develop and update procedures, job aids, and lessons as needed.

Supporting Responsibilities

• Maintain accuracy standards as required to meet department, CMS and PacificSource PRISM measures.
• Meet department and company performance and attendance expectations.
• Attend team, department, company meetings, and mentor lessons as scheduled.
• Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
• Perform other duties as assigned.

Success Profile

• Work Experience: Minimum of 2 years of related medical insurance or healthcare-related experience required.
• Education, Certificates, Licenses: High school diploma or equivalent required.
• Knowledge: Excellent verbal and written communication, basic Excel proficiency, strong typing, and effective problem-solving skills. The ability to proficiently interpret state and federal insurance regulations and maintain knowledge of PacificSource procedures, policies, products, and contracts.
• Competencies: Adaptability Building Customer Loyalty Building Strategic Work Relationships Building Trust Continuous Improvement Contributing to Team Success Planning and Organizing Work Standards Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately less than 5% of the time.

Skills

• Accountability
• Collaboration
• Communication (written/verbal)
• Flexibility
• Listening (active)
• Organizational skills/Planning and Organization
• Problem Solving
• Teamwork

Compensation Disclaimer

The wage range provided reflects the full range for this position. The maximum amount listed represents the highest possible salary for the role and should not be interpreted as a typical starting wage. Actual compensation will be determined based on factors such as qualifications, experience, education, and internal equity. Please note that the stated range is for informational purposes only and does not constitute a guarantee of any specific salary within that range.

Base Range: $35,542.81 - $56,868.50

Our Values

We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:

We are committed to doing the right thing. We are one team working toward a common goal. We are each responsible for customer service. We practice open communication at all levels of the company to foster individual, team and company growth. We actively participate in efforts to improve our many communities-internally and externally. We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community. We encourage creativity, innovation, and the pursuit of excellence.

Physical Requirements

Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.

Disclaimer

This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.

Benefits

• Flexible telecommute policy
• medical
• vision
• and dental insurance
• incentive program
• paid time off and holidays
• 401(k) plan
• volunteer opportunities
• tuition reimbursement and training
• life insurance
• and options such as a flexible spending account

Other Information

PacificSource is anything but a typical health insurance company. Founded in 1933, we're an independent, not-for-profit organization that puts our members, and their communities first - across Idaho, Oregon, Montana, and Washington. It's our employees who make it happen: promoting health equity and partnering with providers to deliver better access to optimal, affordable care. So yes, with PacificSource, you get to do great things. In our effort to put members first - more than 525,000 of them - initiative, commitment, and hard work are supported and rewarded with excellent benefits, competitive wages, and opportunities for personal growth and advancement.

Top Workplace 2026, 2025 and 2024 USA | USA Today 2025 Healthcare Top Workplaces | Energage Top Workplaces # 6 Healthiest Employer of Oregon 2025 | Portland Business Journal Top Workplace 2024, 2023 and 2022 for Oregon and SW Washington | The Oregonian Top Workplace 2025, 2024, 2023 and 2022 for the Treasure Valley | Idaho Press Certified Age Friendly Employer, 2023 | Age Friendly Institute PacificSource is an equal opportunity employer. PacificSource is an equal opportunity employer and a company that loves helping people. We work with our employees to understand their goals, and provide training, individual development, and career advancement opportunities to help them achieve just that.

PacificSource is an equal opportunity employer.