Group Processing Specialist II

PacificSource; United States; On-site; USD 36,000 - 57,000; Full time

Job summary

PacificSource is seeking an experienced group benefits coordinator to process new group setup, renewals, and change requests across small and large insured and self-funded plans. You will prepare materials, ensure accuracy, and work with multiple teams to meet timelines.

The role emphasizes data entry in enrollment systems, validation of codes, and collaboration with Actuarial and Underwriting teams. A Minimum of 2 years in medical insurance is required, with strong communication and Excel

Qualifications

• Minimum of 2 years of related medical insurance or healthcare-related experience.
• High school diploma or equivalent required.
• Strong communication and analytical skills; ability to interpret state and federal insurance regulations.

Responsibilities

• Process new group materials, changes, renewals for various group types.
• Enter and validate group data in enrollment systems and related platforms.
• Coordinate with actuarial/underwriting teams and internal stakeholders.
• Prepare plan materials and issue ID cards with accuracy and timelines.
• Develop procedures and job aids to improve processes.

Skills

Verbal communication

Written communication

Excel proficiency

Typing

Problem solving

Insurance regulations

Education

High school diploma or equivalent

Tools

Facets system

Online Enrollment System

Job description

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.

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.