Operations Claims Associate

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 Operations Claims Associate to join our CMD Claims team in Newport Beach, CA or Omaha, NE.

• This role is hybrid. We believe in empowering our employees to get work done both in and out of the office.

As an Operations Claims Associate you’ll move Pacific Life, and your career, forward by reviewing, processing and paying of contestable and non-contestable death and living claims on both annuity contracts and life insurance policies. You will fill an existing role that sits on a team of 15 people in the Consumer Markets Division. Your colleagues will include Operations Claims Specialists, Senior Operations Claims Specialists and Senior Operations Claims Analysts.

 
How you’ll help move us forward:

• Completes training and masters Foundational Life and Annuity death and living claims functions (as defined per department learning progression). Once cross-trained on functions, can demonstrate a strong technical understanding of process, purpose of steps, and impact to client.

• In-queue and out-of-queue client requests are reviewed against contract/policy information and department procedures to determine good order and necessary steps for resolution; Transaction details are accurately input into administration systems; Final review is completed prior to initiating pay; Takes all appropriate action to ensure a superior service experience.

• Outstanding requirements are accurately and clearly noted, including action to be taken and relevant details of any interaction with client; Notes ensure any future action can be conducted smoothly for the client.

• Prepares before making contact with customers; Follows guidelines for clear and professional verbal and written communication and demonstrates right level of effort to successfully resolve client requests.

• Handles client interactions efficiently while communicating with empathy around sensitive topics.

• Demonstrates ability to navigate to and use appropriate procedural resources; Advises Supervisor of scenarios where documentation may need updating to best support team and/or customer.

• Consistently meets established benchmarks for processing handling times, utilization, accuracy, and service quality; “Escapes” are minimized and within acceptable thresholds, oldest items in queue are worked first, and non-queue processing time is accurately recorded and maps to assignments.

• All discovered errors are reported to minimize impact to client and help leaders identify uptraining opportunities.

• Follows guidelines to appropriately hand off complex or escalated cases to senior team members, ensuring a smooth transition for the customer.

• Adheres to regulatory requirements as defined in current processes.

• Calls and emails are monitored and answered as assigned; Inquiries for advanced topics are forwarded to appropriate senior team members immediately for escalated handling within expected timeframes.

• Follows Operations Call Guidelines during each call, creating a positive service experience for both internal and external callers; Issues are appropriately researched, status on inquiries are provided before department service level expectations, and escalated calls are minimal.

• Effectively drafts emails for outstanding requirements and query responses. Emails follow protocols, are clear, and accurate.

• Documents, notes, job-aids and other appropriate resources are reviewed to ensure accuracy of communication with client; Contract/policy notes accurately reflect contacts, and correctly document status to ensure customer needs are addressed.

• Maintains positive and professional interactions with peers, trainers, internal customers, and leaders across all activities (training, day to day, meetings, etc.). Effectively collaborates to overcome challenges.

• Rotates assignments as requested in support of workflow needs; Accepts temporary assignments within Operations in support of other departments or contingency planning, as directed by Supervisor.

• Demonstrates awareness of the Workday Performance Mgmt. and goal writin