Senior Life Claims Specialist

Pacific Life; Omaha (NE); On-site; 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

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 Sr. Life Claims Specialist to join the Workforce Benefits Division team in Omaha NE (4 days in office required) or remote in Tennessee.

How you'll help move us forward:

• Serve as a subject matter expert on Life claim practices, consulting on best practices and contributing to the design and refinement of internal procedures, workflows, and system requirements.
• Mentor and support onboarding of new team members; share expertise and foster knowledge growth within the team.
• Proactively identify process gaps or opportunities and contribute to continuous improvement efforts and enterprise initiatives.
• Manage a caseload of Group Life insurance claims that will include life, accelerated benefit, accidental death and dismemberment, and life waiver of premium claims from initial review through resolution.
• Apply policy provisions to evaluate eligibility, validate beneficiary information, and gather all required documentation.
• Analyze claim documentation such as beneficiary designations, autopsy, accident reports, medical, financial, and any other documentation to assess claim impact.
• Make timely and accurate decisions by using critical thinking, adherence to policy provisions and sound problem solving skills.
• Accurately document decisions, rationale, and customer interactions.
• Communicate clearly and empathetically with claimants, beneficiaries, employers, and internal stakeholders.
• Collaborate across business functions to ensure a seamless and compliant claims experience.
• Demonstrate agility in adapting to changing priorities, business needs, and regulatory requirements.
• Maintain a high level of confidentiality, professionalism, and integrity in all claim-related activities.
• Perform other duties as assigned.

The experience you bring:

• Bachelor’s degree or equivalent work experience preferred 5–7+ years of Life Insurance claims experience required, including adjudication of complex claims such as contestability reviews, exclusions, beneficiary disputes, Demonstrated expertise in investigating, evaluating, and adjudicating life insurance claims from initial notice through claims decision in accordance with policy provisions and company guidelines Proven ability to interpret policy language, contractual provisions, and beneficiary designations, ensuring accurate, consistent, and defensible claim outcomes Possesses a strong knowledge of group life insurance policies, as well as knowledge of relevant regulatory and statutory requirements such as FMLA, ERISA, and HIPAA. Strong working knowledge of state insurance regulations, ERISA (as applicable), and claims compliance standards, with the ability to apply regulatory requirements to complex claim scenarios Demonstrated ability to manage a full caseload independently, effectively prioritizing competing demands while meeting service, quality, and turnaround expectations Advanced analytical and critical thinking skills, including the ability to evaluate medical records, cause of death, financial documentation, and legal instruments (e.g., trusts, assignments, probate) Strong communication skills with the ability to effectively engage with beneficiaries, funeral homes, attorneys, medical providers, and internal partners, delivering clear, timely, and compassionate communication throughout the claims process Demonstrated commitment to a customer-centric claims philosophy, with a strong focus on empathy, care, and respect, recognizing the sensitive nature of life claims and the impact on beneficiaries and families Demonstrated ability to navigate grief and emotionally complex situations with sensitivity and care, adapting communication style to meet individuals where they are and ensuring beneficiaries feel supported, respected, and treated with dignity Highly organized and detail-oriented, ensuring accurate benefit calculations, thorough documentation, and complete claim file management in support of audit readiness and defensibility Demonstrates ownership of outcomes, with a focus on timely, accurate, and customer-centered claim resolutions that build trust and confidence

What makes you stand out:

• Ability to work independently while also serving as a subject matter expert and resource for less experienced team members, providing guidance and informal mentorship
• Ability to manage multiple priorities and adapt quickly in a fast-paced, evolving environment while maintaining quality and consistency
• Experience with claims administration systems and workflow tools; ability to quickly develop and maintain strong knowledge of Pacific Life’s Workforce Benefits platforms and processes
• Possesses a strong knowledge of group life insurance policies, as well as knowledge of relevant regulatory and statutory requirements such as FMLA, ERISA, and HIPAA.

#LI-KB1 Base 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. $35.22 - $43.04

Your Benefits Start Day 1

Your 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, or 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 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

We Can Be Who You Are

EEO 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.

Pacific Life is more than a job — it’s a career with purpose.

For nearly 160 years, we’ve helped people protect their financial futures through strength, stability, and innovation.

Join us to make a meaningful impact and build a career where you can thrive.

Learn more.

Pacific Life's success is driven by our people.

We create, embrace and sustain an inclusive workplace where all employees are respected and supported throughout their career.

Our values inspire and direct our actions shaping the vibrant culture we proudly uphold.