Senior Life Claims Expert – Remote/Hybrid

Pacific Life; Omaha (NE); Hybrid; USD 4,852,000 - 5,929,000; Full time

Benefits offered by this job

Medical, Dental, Vision

Paid Time Off

401k with company match

Adoption Assistance

Job summary

Pacific Life Insurance Company seeks a Sr. Life Claims Specialist to join the Workforce Benefits Division in Omaha, NE (4 days in office) or remote in Tennessee. The role requires expert life claim knowledge and the ability to manage complex claims from initial review to final decision.

You will mentor teammates, drive process improvements, and partner across functions to provide a compassionate, compliant claims experience while maintaining confidentiality.

Qualifications

• Bachelor’s degree or equivalent work experience; 5–7+ years of Life Insurance claims experience required.
• Expertise in adjudicating life insurance claims from notice to decision per policy provisions.
• Knowledge of FMLA, ERISA, HIPAA regulations and state insurance rules.
• Strong analytical skills for evaluating medical, financial and legal documents.
• Excellent communication with claimants, beneficiaries, and internal partners.

Responsibilities

• Manage a caseload of Group Life insurance claims from initial review through decision.
• Apply policy provisions to determine eligibility and required documentation.
• Assess claim materials (autopsy, medical, financial, beneficiary designations).
• Document decisions and communicate empathetically with claimants.
• Collaborate across functions to ensure compliant, end-to-end claims experience.
• Identify process improvements and support enterprise initiatives.
• Maintain confidentiality and audit-ready file quality.

Skills

Life insurance claims

Claims adjudication

Regulatory knowledge (ERISA, HIPAA, F–

Education

Bachelor’s degree or equivalent work experience

Tools

Claims systems

Workflow tools

Pacific Life Workforce Benefits platforms

Job description

Pacific Life Insurance Company seeks a Sr. Life Claims Specialist to join the Workforce Benefits Division in Omaha, NE (4 days in office) or remote in Tennessee. The role requires expert life claim knowledge and the ability to manage complex claims from initial review to final decision.

You will mentor teammates, drive process improvements, and partner across functions to provide a compassionate, compliant claims experience while maintaining confidentiality.