Operations Claims Specialist

Role overview

Pacific Life is looking for an Operations Claims professional to support its Consumer Markets Division claims processing team. The position is based in Omaha, NE or Charlotte, NC and follows a hybrid arrangement with one day per week in the office. The role centers on handling insurance claim work accurately, on time, and in line with policy, contract, and compliance requirements while providing strong service to customers and internal teams.

This opening may be hired at one of several levels depending on experience and business need: Operations Claims Associate, Operations Claims Specialist, Sr. Operations Claims Specialist, or Sr. Operations Claims Analyst.

Claims processing and adjudication

• Evaluate claims against the relevant contract and policy terms to confirm the right outcome and correct processing.
• Complete transactions with precision, including full supporting documentation and payment checks.
• Pinpoint any missing items and note the follow-up steps needed.
• Keep claim records detailed and current so the next person can easily continue the work.
• Work within regulatory, compliance, and internal procedure standards at all times.

Customer and partner communication

• Answer inquiries from customers and internal partners by phone and email.
• Handle sensitive claim conversations with professionalism, clarity, and empathy.
• Research questions and resolve claim issues within expected service timelines.
• Escalate complicated or higher-risk matters when needed.

Operational excellence and risk management

• Weigh accuracy, speed, and risk control when making claims decisions.
• Spot mistakes, workflow gaps, and opportunities to improve the process, then report them.
• Use approved procedures, job aids, and knowledge tools to support daily work.
• Help manage queue priorities and balance workload across the team.

Collaboration and team support

• Work with peers, leaders, and other functions to solve issues.
• Support team coverage needs and participate in rotating functional assignments.
• Contribute to a respectful, cooperative team culture.

Leadership, training, and continuous improvement for senior levels

• Coach and mentor teammates and provide peer training.
• Perform quality checks and look for trends in errors or outcomes.
• Assist with process enhancements, documentation updates, and project work.
• Act as a resource for complex or escalated claims.

Experience and qualifications

Applicants should bring a mix of claims knowledge, problem-solving ability, and strong communication skills. Experience expectations vary by level:

• Operations Claims Associate: 0 to 2 years of operations or insurance-related experience.
• Operations Claims Specialist: 2 to 3+ years of claims processing experience with solid proficiency.
• Sr. Operations Claims Specialist: 3+ years of advanced claims experience, including complex or contestable claims.
• Sr. Operations Claims Analyst: 5+ years of experience, including expertise with complex or contestable claims.
• Strong analytical thinking, critical judgment, and troubleshooting ability.
• Careful attention to detail and the ability to handle several priorities at once.
• Comfort working in a fast-moving setting where accuracy and efficiency both matter.
• Strong written and verbal communication skills, especially in sensitive situations.
• Ability to work independently as well as with a team.

Preferred background

• Prior exposure to life insurance claims and/or annuity claims.
• Experience working on contestable claims or investigations.
• Background in mentoring, coaching, or training others.

Education

A bachelor’s degree is preferred, or an equivalent combination of education and relevant experience.

Compensation

Pay varies by level, experience, qualifications, and location. The following compensation ranges were provided for Omaha and Charlotte:

• Operations Claims Associate: Omaha $24–$26 per hour; Charlotte $25–$27 per hour.
• Operations Claims Specialist: Omaha $26–$28 per hour; Charlotte $27–$29 per hour.
• Sr. Operations Claims Specialist: Omaha $32–$34; Charlotte $33–$36.
• Sr. Operations Claims Analyst: Omaha $39–$41; Charlotte $41–$43.

The base pay range for this role is $22.81 to $27.87 per hour. Final compensation depends on experience, qualifications, and geographic location. Many employees are also eligible for additional incentive pay.

Benefits

• Medical, dental, vision, and wellbeing reimbursement support for employees and eligible dependents.
• Paid time off options, holiday schedules, and financial planning time off.
• Paid parental leave and adoption assistance.
• 401(k) savings plan with company match plus an extra company contribution regardless of participation.

Diversity, inclusion, and accommodations

The company emphasizes an inclusive environment where employees, partners, and communities can be authentic and supported to reach their potential. Pacific Life is an equal opportunity and affirmative action employer. Candidates who are qualified individuals with disabilities or disabled veterans may request accommodation if needed to access the career center or apply due to a disability.