Operations Claims Specialist

Pacific Asset Management, LLC; Charlotte (NC); Hybrid; USD 52,000 - 99,000; Full time

Benefits offered by this job

Medical coverage

Dental & Vision

401k with company match

Paid time off

Parental leave

Job summary

Pacific Life Insurance Company is seeking an Operations Claims professional to join a hybrid team in Omaha, NE or Charlotte, NC, processing life and annuity claims with a focus on accuracy, compliance, and service excellence. The role offers progression from Associate to Sr.

roles, with compensation varying by level and location. You will engage with customers and internal partners, handling sensitive claims and contributing to process improvements within a collaborative, professional

Qualifications

• Strong analytical, critical thinking, and problem-solving skills.
• High attention to detail with ability to manage multiple priorities.
• Strong written and verbal communication skills, including handling sensitive situations with empathy.

Responsibilities

• Review and adjudicate claims against contracts and policy provisions for accuracy.
• Respond to customer and internal partner inquiries with clear, professional, empathetic communication.
• Balance accuracy, efficiency, and risk, and identify process improvements.
• Collaborate with cross-functional teams to resolve issues and support workload balancing.
• Mentor or train junior staff and contribute to documentation and continuous improvement.

Skills

Analytical thinking

Attention to detail

Communication skills

Team collaboration

Education

Bachelor’s degree or equivalent

Job description

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.We’re actively seeking a talented Operations Claims professional to join our Operations Claims processing team within the Consumer Markets Division (CMD) in Omaha, NE or Charlotte, NC. This role follows a hybrid schedule of one day a week in office.As part of the Claims processing team, you’ll move Pacific Life, and your career, forward by ensuring accurate, timely, and compliant processing of insurance claims while delivering exceptional service to customers and internal partners. You will review and process contestable and non-contestable death and living claims on both annuity contracts and life insurance policies.This position may be filled at the Operations Claims Associate, Operations Claims Specialist, Sr. Operations Claims Specialist, or Sr. Operations Claims Analyst level based on experience and business needs, and we are open to hiring across all levels.How you’ll help move us forward:Claims Processing & AdjudicationReview claims against contract and policy provisions to ensure accuracy and appropriate resolutionProcess transactions accurately with complete documentation and payment validationIdentify and document outstanding requirements and required next stepsMaintain clear and detailed claim notes for continuity of serviceEnsure adherence to regulatory, compliance, and procedural standardsCustomer & Partner CommunicationRespond to customer and internal partner inquiries via phone and emailCommunicate clearly, professionally, and with empathy, especially in sensitive claim situationsResearch and resolve claim-related inquiries within service level expectationsEscalate complex or high-risk issues appropriatelyOperational Excellence & Risk ManagementBalance accuracy, efficiency, and risk mitigation in claims decisionsIdentify and report errors, process gaps, and improvement opportunitiesFollow established procedures, job aids, and knowledge resourcesSupport workload balancing and queue management prioritiesCollaboration & Team SupportPartner with peers, leadership, and cross-functional teams to resolve issuesSupport team workflow needs and participates in functional rotationsContribute to a professional, collaborative team environmentLeadership, Training & Continuous Improvement (Sr. Operations Claims Specialist)Provide mentoring, coaching, and peer trainingConduct quality reviews and identify trendsSupport process improvements, documentation updates, and project initiativesServe as a subject matter expert for complex or escalated claimsThe experience you bring:Operations Claims Associate: 0–2 years of operations or insurance-related experienceOperations Claims Specialist: 2–3+ years of claims processing experience with demonstrated proficiencySr. Operations Claims Specialist: 3+ years of advanced claims experience, including complex or contestable claimsSr. Operations Claims Analyst: 5+ years of experience with expertise in complex or contestable claimsStrong analytical, critical thinking, and problem-solving skillsHigh attention to detail with ability to manage multiple prioritiesAbility to balance accuracy and efficiency in a fast-paced environmentStrong written and verbal communication skills, including handling sensitive situations with empathyAbility to work both independently and collaborativelyWhat makes you stand out:Experience with life insurance and/or annuity claimsExperience handling contestable claims or investigationsExperience with training, mentoring, or coachingEducation Requirements:Bachelor’s degree or equivalent combination of education and experienceLevel Differentiation & Compensation:Compensation will vary depending on level, experience, and qualifications, and location.Operations Claims AssociateEntry-level role focused on developing foundational claims knowledge and skillsOmaha Compensation: $24 - $26/hr.Charlotte Compensation: $25 - $27/hr.Operations Claims SpecialistIndependently performs advanced claims transactions and meets performance expectationsOmaha Compensation: $26 - $28/hr.Charlotte Compensation: $27 - $29/hr.Sr. Operations Claims SpecialistHandles complex or contestable claims and contributes to training, quality, and process improvement effortsOmaha Compensation: $32 - $34Charlotte Compensation: $33 - $36Sr. Operations Claims AnalystServes as subject matter expert and leads complex investigations and cross-functional initiativesOmaha Compensation: $39 - $41Charlotte Compensation: $41 - $43#LI-RB1Base Pay Range:The base pay range noted represents the company’s good faith minimum and maximum range for this role at the time of posting. The actual compensation offered to a candidate will be dependent upon several factors, including but not limited to experience, qualifications and geographic location. Also, most employees are eligible for additional incentive pay.Your Benefits Start Day 1Your wellbeing is important to Pacific Life, and we’re committed to providing you with flexible benefits that you can tailor to meet your needs. Whether you are focusing on your physical, financial, emotional, or social wellbeing, we’ve got you covered.Prioritization of your health and well-being including Medical, Dental, Vision, and Wellbeing Reimbursement Account that can be used on yourself or your eligible dependentsGenerous paid time off options including: Paid Time Off, Holiday Schedules, and Financial Planning Time OffPaid Parental Leave as well as an Adoption Assistance ProgramCompetitive 401k savings plan with company match and an additional contribution regardless of participationYou Can Be Who You AreWe are committed to a culture of diversity and inclusion that embraces the authenticity of all employees, partners and communities. We support all employees to thrive and achieve their fullest potential.What’s life like at Pacific Life? Visit Instagram.com/lifeatpacificlifeEEO Statement:Pacific Life Insurance Company is an Equal Opportunity /Affirmative Action Employer, M/F/D/V. If you are a qualified individual with a disability or a disabled veteran, you have the right to request an accommodation if you are unable or limited in your ability to use or access our career center as a result of your disability. To request an accommodation, contact a Human Resources Representative at Pacific Life Insurance Company.