Pacific Life
Pacific Life
Pacific Life je družba za finančne storitve in zavarovanje, ki se osredotoča na pomoč posameznikom, družinam, podjetjem in ustanovam pri pripravi na prihodnost. Njena ponudba vključuje življenjsko zavarovanje, rente, rešitve za upokojitev in ugodnosti za zaposlene. Družba, ustanovljena leta 1868, združuje dolgoletne izkušnje na področju finančne zaščite z osredotočenostjo na razvoj izdelkov, ki podpirajo dolgoročno finančno varnost in pomembne rezultate za svoje stranke.

Senior Life Claims Specialist – Pacific Life

Handle complex group life insurance claims at Pacific Life, reviewing policy terms, beneficiary disputes, and supporting records to reach compliant decisions. The role also provides claims expertise, supports team onboarding, and contributes to process improvements.

Opis

  • Serve as a subject matter expert on life claims practices.
  • Advise on best practices and help shape internal procedures, workflows, and system requirements.
  • Guide new team members and support their onboarding.
  • Spot process gaps and contribute to continuous improvement and enterprise initiatives.
  • Oversee group life insurance claims from initial review through resolution.
  • Assess eligibility and verify beneficiary details against policy provisions.
  • Collect and review beneficiary, autopsy, accident, medical, financial, and other claim records.
  • Reach timely, accurate claim decisions.
  • Record decisions, supporting rationale, and customer interactions.
  • Communicate with claimants, beneficiaries, employers, and internal partners with clarity and empathy.
  • Coordinate across business functions to deliver a compliant, seamless claims experience.
  • Adjust to shifting priorities, business needs, and regulatory requirements.
  • Protect confidential information and act with professionalism and integrity.
  • Handle other assigned duties.

Zahteve

  • A bachelor’s degree or equivalent work experience is preferred.
  • At least 5–7 years of life insurance claims experience is required, including adjudicating complex claims.
  • Experience reviewing contestability, exclusions, and beneficiary disputes.
  • Expertise investigating, assessing, and adjudicating life insurance claims from initial notice to decision.
  • Ability to interpret policy language, contract provisions, and beneficiary designations.
  • Strong understanding of group life insurance policies.
  • Knowledge of FMLA, ERISA, HIPAA, state insurance regulations, and claims compliance standards.
  • Ability to manage a full caseload independently and prioritize competing demands.
  • Advanced analytical and critical thinking skills.
  • Ability to assess medical records, cause of death, financial documents, and legal instruments.
  • Strong communication skills with beneficiaries, funeral homes, attorneys, medical providers, and internal partners.
  • A customer-focused approach grounded in empathy, care, and respect.
  • Ability to handle grief and emotionally difficult situations with sensitivity.
  • Highly organized and attentive to detail.
  • Ability to calculate benefits accurately and maintain thorough documentation and complete claim files.
  • Ability to work independently as a subject matter expert and mentor less experienced team members.
  • Ability to juggle priorities and adapt in a fast-paced environment.
  • Experience using claims administration systems and workflow tools.

Ugodnosti

  • Medical, dental, and vision coverage.
  • Wellbeing reimbursement account for employees and eligible dependents.
  • Paid time off.
  • Holiday schedules.
  • Financial planning time off.
  • Paid parental leave.
  • Adoption assistance program.
  • Competitive 401(k) savings plan with company match.
  • Additional 401(k) contribution regardless of participation.
  • Flexible benefits tailored to employee needs.
  • Diversity and inclusion support.

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