Eligibility & Member Support Specialist

Pacific Life • Omaha, TN

1d • $25 - $32

About The Position

Providing for loved ones, planning rewarding retirements, saving enough for whatever lies ahead – our policyholders count on us to be there when it matters most. It’s a big ask, but it’s one that we have the power to deliver when we work together. We collaborate and innovate – pushing one another to transform not just Pacific Life, but the entire industry for the better. Why? Because it’s the right thing to do. Pacific Life is more than a job, it’s a career with purpose. It’s a career where you have the support, balance, and resources to make a positive impact on the future – including your own. We’re actively seeking several talented Eligibility & Member Support Specialists to join our Employer Services’ Team in Omaha, NE or Chattanooga, TN As an Eligibility and Member Support Specialist, you’ll move Pacific Life, and your career, forward by playing a key role in auditing and resolving discrepancies based on employer’s product configuration & the member level data received while delivering a first-class friction free experience to our employers in the Workforce Benefits Division. You will fill a new role that sits on a team of 15 people in the Workforce Benefits Division. Your colleagues will include Eligibility, Account Executives and Billing professionals. How you’ll help move us forward: Responsible for working independently with brokers and employers to research, problem-solve and remediate inforce client challenges related to member management. Identifies root causes of complex member level discrepancies by researching plan design, rates, file feed data, kick outs and doing comparisons to Administration System and TPA information often arising during billing, renewals, amendments, and open enrollments. Understands end to end impact of policy, rate, & member level changes to eligibility and billing/premium with the ability to build a resolution plan to remediate. Identifies needed changes to update member level data and coordinate along with file feeds to ensure system data is accurate. Ability to leverage data from multiple sources and use tools and formulas to expediate large comparisons. Determines any back charges or credits that need reviewed for accuracy and can work with Underwriting, Billing and Distribution to discuss any needed negotiations on due amounts. Consults with clients and make decisions aligned with our organization operating model to ensure issues and/or requests are fully resolved. Build strong relationships with Sales/Distribution, Brokers and Employers as a trusted advisor within our Workforce Benefits Division. Coordinate, manage and lead conversations with Employers, Brokers and other partners to provide exceptional customer experience. Owns issues to ensure timely resolution and escalates to management with recommendations on how to address unresolved service issues. Follows-up and provides transparent communications on the status of outstanding issues as needed. Understands the full Broker, Employer, and Employee journey to deliver elevated service in issue resolution. Works within departmental controls for all aspects of the role with a high standard of ethics. Strong knowledge of our product offering, system(s), and processes as well as understand how data flows throughout employer and employee journeys. Participates and contributes to team meetings or special tasks and assignments and brings innovative ideas and a continuous improvement mindset to the department. Job performance must meet department standards for work prioritization, productivity, quality and timeliness. Identifies, understands and ensures that actions, behaviors and decisions are consistent with the department, division and Pacific Life Mission & Vision.

Requirements

• College degree or equivalent experience preferred.
• 3-5 years of financial services, product compliance or group benefits operations experience
• Needs to be an effective communicator with externally facing presence.
• Customer-centric with problem-solving skillset
• Detail Oriented
• Requires strong analytical skills
• Demonstrated time management and organizational skills
• Intermediate skills with MS office applications
• Will need to gain expert knowledge of Pacific Life’s Workforce Benefits platforms such as policy admin and workflow tools.

Nice To Haves

• Experience in Eligibility and Evidence of Insurability at a group carrier
• Prior work in EIS System
• Expert level experience in Excel

Responsibilities

• Responsible for working independently with brokers and employers to research, problem-solve and remediate inforce client challenges related to member management.
• Identifies root causes of complex member level discrepancies by researching plan design, rates, file feed data, kick outs and doing comparisons to Administration System and TPA information often arising during billing, renewals, amendments, and open enrollments.
• Understands end to end impact of policy, rate, & member level changes to eligibility and billing/premium with the ability to build a resolution plan to remediate.
• Identifies needed changes to update member level data and coordinate along with file feeds to ensure system data is accurate.
• Ability to leverage data from multiple sources and use tools and formulas to expediate large comparisons.
• Determines any back charges or credits that need reviewed for accuracy and can work with Underwriting, Billing and Distribution to discuss any needed negotiations on due amounts.
• Consults with clients and make decisions aligned with our organization operating model to ensure issues and/or requests are fully resolved.
• Build strong relationships with Sales/Distribution, Brokers and Employers as a trusted advisor within our Workforce Benefits Division.
• Coordinate, manage and lead conversations with Employers, Brokers and other partners to provide exceptional customer experience.
• Owns issues to ensure timely resolution and escalates to management with recommendations on how to address unresolved service issues.
• Follows-up and provides transparent communications on the status of outstanding issues as needed.
• Understands the full Broker, Employer, and Employee journey to deliver elevated service in issue resolution.
• Works within departmental controls for all aspects of the role with a high standard of ethics.
• Strong knowledge of our product offering, system(s), and processes as well as understand how data flows throughout employer and employee journeys.
• Participates and contributes to team meetings or special tasks and assignments and brings innovative ideas and a continuous improvement mindset to the department.
• Job performance must meet department standards for work prioritization, productivity, quality and timeliness.
• Identifies, understands and ensures that actions, behaviors and decisions are consistent with the department, division and Pacific Life Mission & Vision.

Benefits

• Prioritization of your health and well-being including Medical, Dental, Vision, and Wellbeing Reimbursement Account that can be used on yourself or your eligible dependents
• Generous paid time off options including: Paid Time Off, Holiday Schedules, and Financial Planning Time Off
• Paid Parental Leave as well as an Adoption Assistance Program
• Competitive 401k savings plan with company match and an additional contribution regardless of participation

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level