Responsible for working independently with brokers and employers to research, problem-solve and remediate in-force 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.
Understands end-to-end impact of policy, rate, & member level changes to eligibility and billing/premium.
Identifies needed changes to update member level data and coordinate along with file feeds to ensure system data is accurate.
Leverages data from multiple sources and use tools and formulas to expedite large comparisons.
Determines any back charges or credits that need reviewed for accuracy.
Consults with clients and makes decisions aligned with our organization operating model.
Builds strong relationships with Sales/Distribution, Brokers and Employers.
Owns issues to ensure timely resolution and escalates to management with recommendations.

College degree or equivalent experience preferred.
3-5 years of financial services, product compliance or group benefits operations experience.
Effective communicator with externally facing presence.
Customer-centric with problem-solving skillset.
Detail Oriented.
Strong analytical skills.
Demonstrated time management and organizational skills.
Intermediate skills with MS office applications.
Expert knowledge of Pacific Life’s Workforce Benefits platforms such as policy admin and workflow tools.

Eligibility & Member Support Specialist

Key skills