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Eligibility and Member Services Specialist

Date Posted: Oct 15, 2026
Yearly: USD - USD

Job Detail

  • location_on
    Location Omaha, Nebraska, United States of America
  • desktop_windows
    Job Type: Permanent
  • schedule
    Shift:
  • analytics
    Career Level:
  • group
    Positions:
  • calendar_view_day
    Experience:
  • male
    Gender: No Preference
  • school
    Degree:
  • calendar_month
    Apply Before: Jan 14, 2027

Job Description

Overview

Job Description: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 a talented Eligibility & Member Services Specialist to join our Employer Services Team in Omaha, NE.As a Eligibility and Member Services 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:Work independently with brokers and employers to research, problem-solve 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, kick outs and doing comparisons to Administration System and TPA information often arising during billing, renewals, amendments, and open enrollments.Understand 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.Identify needed changes to update member level data and coordinate along with file feeds to ensure system data is accurate.Leverage data from multiple sources and use tools and formulas to expediate large comparisons.Determine 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.Consult 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.Own issues to ensure timely resolution and escalates to management with recommendations on how to address unresolved service issues.Follow-up and provide transparent communications on the status of outstanding issues as needed.Understand the full Broker, Employer, and Employee journey to deliver elevated service in issue resolution.Work 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.Participate and contribute to team meetings or special tasks and assignments and brings innovative ideas and a continuous improvement mindset to the department.The experience you bring:College degree or equivalent experience preferred.3-5 years of financial services, product compliance or group benefits operations experienceNeeds to be an effective communicator with externally facing presence.Customer-centric with problem-solving skillsetDetail-orientedStrong analytical skillsDemonstrated time management and organizational skillsIntermediate skills with MS office applicationsWhat makes you stand out:Experience in Eligibility and Evidence of Insurability at a group carrierPrior work in EIS SystemExpert level experience in ExcelBase Pay Range:The base pay range

Key responsibilities

Not specified in the original listing.

Required skills

  • Administration

What the company offers

Not specified in the original listing.

Skills Required

Company Overview

Newport Beach, Baja California, United States of America

Pacific Life is a financial services company that provides policies and financial products for retirement planning and wealth management. The organization emphasizes collaboration, innovation, and a career with purpose, supporting employees in making... Read More

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