Member Services Specialist - Benefits & Claims

Pacific Administrators; Honolulu (HI); On-site; USD 38,000 - 50,000; Full time

Benefits offered by this job

Medical, Dental, Vision Insurance

Paid Vacation, Sick and Personal Time

401(k) Plan with Company Match

Commuter Benefit

Job summary

Pacific Administrators in Hawaii is seeking a Member Services Clerk I to assist members and providers with benefit, claim and eligibility information. You will work under the Member Services Supervisor to create documentation directing action for resolution and accurate benefit administration.

The role emphasizes accurate data handling, timely responses, and professional communication. Requires college study or equivalent experience, strong MS Office skills, 45 WPM typing, and a customer-focused

Qualifications

• Minimum of 2 years college education or 4 years work experience in related field.
• Excellent Customer Service and Communication Skills.
• Highly Proficient in Microsoft Word, Excel, and PowerPoint.
• 10-key by touch.
• Typing 45 WPM.
• Good Communication Skills (written and verbal).
• Quick learner with the desire and initiative to keep learning.
• Strong organizational and multi-tasking skills.
• Strong concentration, listening and problem-solving skills.

Responsibilities

• Access, interpret and analyze information in databases and manuals.
• Respond and follow-up to member/provider inquiries in a timely and professional manner.
• Communicate accurate membership, benefit and claims information in response to inquiries verbally or in writing; escalate exceptional cases.
• Know the benefits for designated Health and Welfare accounts.
• Identify questions or concerns via clarifying questions and file research.
• Create, log and track contacts requiring further action; maintain pending follow-up.
• Update records and process various Fund benefits daily (age 26 notifications, address changes, COBRA, etc.).
• File documents to each member's folder for accurate record keeping.
• Present information professionally and to the company’s standards.
• Assist supervisor/manager with other duties or projects.

Skills

Customer service

Communication

MS Office

10-key by touch

Typing 45 WPM

Organizational skills

Multitasking

Problem solving

Attention to detail

Education

2 years college / 4 years experience

Job description

Pacific Administrators in Hawaii is seeking a Member Services Clerk I to assist members and providers with benefit, claim and eligibility information. You will work under the Member Services Supervisor to create documentation directing action for resolution and accurate benefit administration.

The role emphasizes accurate data handling, timely responses, and professional communication. Requires college study or equivalent experience, strong MS Office skills, 45 WPM typing, and a customer-focused