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Claims Processing Manager Jobs in Nebraska (NOW HIRING)

Pacificlife

Operations Claims Specialist

Omaha, NE

$26/hr

As part of the Claims processing team, you'll move Pacific Life, and your career, forward by ... Support workload balancing and queue management priorities Collaboration & Team Support * Partner ...

Mutual of Omaha

Absence Claims Team Leader

Omaha, NE · On-site +1

$80K - $95K/yr

Lead and manage the Absence Claims department, overseeing staffing, performance, and compliance with policies. * Develop, implement, and monitor quality assurance processes, ensuring timely and ...

CSAA

Job Title Process Manager, Commercial Casualty Claims - Remote Requisition Number R7810 Process Manager, Commercial Casualty Claims - Remote (Open) Location California - Home Teleworkers Additional ...

NRECA

Disability Claims Specialist

Lincoln, NE · On-site

... compensation claims processing working with group insurance plans and service providers ... The preceding has been written to reflect management's assignment of essential functions. It does ...

Great American Insurance Group

A process driven organization can lose sight of the true purpose of managing claims -- good outcomes on each claim. Managing in that processing environment can feel robotic. Strategic Comp is a ...

Rocket Carwash

Claims Specialist

La Vista, NE · On-site

$60K - $80K/yr

Claims Specialist Position Summary Rocket Carwash is reaching new heights with an electrifying pace ... throughout this process and bring up recommendations for implementation. * Manage workflow ...

Lincoln Financial

Specialist, Appeals Claims

Papillion, NE · Remote

$74K - $78K/yr

You will provide technical information and detailed guidance to Claims management & teams regarding products, claims processes, regulations, and applicable systems for their assigned claims area. If ...

Lincoln Financial

Specialist, Appeals Claims

Papillion, NE · On-site

$74K - $78K/yr

You will provide technical information and detailed guidance to Claims management & teams regarding products, claims processes, regulations, and applicable systems for their assigned claims area. If ...

Lincoln Financial

Specialist, Appeals Claims

Omaha, NE · Remote

$74K - $78K/yr

You will provide technical information and detailed guidance to Claims management & teams regarding products, claims processes, regulations, and applicable systems for their assigned claims area. If ...

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Claims Processing Manager information

Have a claim synonym?

For a Claims Processing Manager, a synonym for 'claim' is often 'request for payment' or 'insurance request.' These terms are used interchangeably in the context of insurance and claims processing roles. Understanding these synonyms can help in effective communication and documentation within the job environment.

What are the three main claims?

In claims processing, the three main types of claims are first-party claims, which involve the policyholder's own coverage; third-party claims, which involve a claim against another party's insurance; and liability claims, which determine legal responsibility for damages. Claims adjusters evaluate these claims to determine coverage and settlement amounts, often using specialized software and industry standards.

What are the primary challenges faced by a Claims Processing Manager, and how can they be addressed?

Claims Processing Managers often navigate challenges such as ensuring timely and accurate claim adjudication, managing a team with varying workloads, and staying up to date with regulatory changes. Balancing efficiency with compliance requires strong organizational skills and effective communication. Successful managers foster a collaborative environment, implement regular training, and leverage technology to streamline processes, all while maintaining high standards of customer service and data integrity.

What is the meaning of a claim?

In the context of a Claims Processing Manager, a claim is a formal request made by an insured individual or policyholder to an insurance company for coverage or compensation for a loss or damage covered under their policy. Processing claims involves reviewing documentation, verifying coverage, and determining the appropriate payout. Accurate claim handling requires knowledge of insurance policies, attention to detail, and adherence to regulatory standards.

What does a Claims Processing Manager do?

A Claims Processing Manager oversees the team responsible for reviewing, evaluating, and processing insurance claims. Their duties include ensuring claims are handled efficiently and accurately, developing procedures to improve workflow, and maintaining compliance with industry regulations. They also resolve complex or escalated claims issues, provide staff training, and report on performance metrics. The role requires strong leadership, analytical skills, and attention to detail to ensure a fair and timely claims process.

What are examples of claims?

In claims processing, examples include insurance claims for damages, medical claims for healthcare expenses, and warranty claims for product repairs or replacements. Claims are submitted by policyholders or customers to request coverage or compensation, and processing involves verifying details and determining payout eligibility. Claims processing managers oversee this workflow, ensuring accuracy and efficiency using claims management systems.

What are the key skills and qualifications needed to thrive as a Claims Processing Manager, and why are they important?

To thrive as a Claims Processing Manager, you need expertise in insurance claims procedures, analytical skills, and a solid understanding of regulatory compliance, often supported by a bachelor's degree and relevant industry experience. Familiarity with claims management software, workflow automation tools, and data analysis systems is typically required. Strong leadership, attention to detail, and effective communication are crucial soft skills that set top performers apart in this role. These abilities ensure accurate and efficient claims processing, regulatory adherence, and effective team management, all of which are vital for organizational success.
Claims Processing Manager jobs near you
Operations Claims Specialist

Operations Claims Specialist

Pacific Life Insurance Company

Omaha, NE • On-site

$27 - $29/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 13 days ago

Pacific Life rating

6.8

Company rating: 6.8 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

231st of 262 rated insurance

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.
We're actively seeking a talented Operations Claims professional to join our Operations Claims processing team within the Consumer Markets Division (CMD) in Omaha, NE or Charlotte, NC. This role follows a hybrid schedule of one day a week in office.
As part of the Claims processing team, you'll move Pacific Life, and your career, forward by ensuring accurate, timely, and compliant processing of insurance claims while delivering exceptional service to customers and internal partners. You will review and process contestable and non-contestable death and living claims on both annuity contracts and life insurance policies.
This position may be filled at the Operations Claims Associate, Operations Claims Specialist, Sr. Operations Claims Specialist, or Sr. Operations Claims Analyst level based on experience and business needs, and we are open to hiring across all levels.
How you'll help move us forward:
Claims Processing & Adjudication
  • Review claims against contract and policy provisions to ensure accuracy and appropriate resolution
  • Process transactions accurately with complete documentation and payment validation
  • Identify and document outstanding requirements and required next steps
  • Maintain clear and detailed claim notes for continuity of service
  • Ensure adherence to regulatory, compliance, and procedural standards

Customer & Partner Communication
  • Respond to customer and internal partner inquiries via phone and email
  • Communicate clearly, professionally, and with empathy, especially in sensitive claim situations
  • Research and resolve claim-related inquiries within service level expectations
  • Escalate complex or high-risk issues appropriately

Operational Excellence & Risk Management
  • Balance accuracy, efficiency, and risk mitigation in claims decisions
  • Identify and report errors, process gaps, and improvement opportunities
  • Follow established procedures, job aids, and knowledge resources
  • Support workload balancing and queue management priorities

Collaboration & Team Support
  • Partner with peers, leadership, and cross-functional teams to resolve issues
  • Support team workflow needs and participate in functional rotations
  • Contribute to a professional, collaborative team environment

Leadership, Training & Continuous Improvement (Sr. Operations Claims Specialist)
  • Provide mentoring, coaching, and peer training
  • Conduct quality reviews and identify trends
  • Support process improvements, documentation updates, and project initiatives
  • Serve as a subject matter expert for complex or escalated claims

The experience you bring:
  • Operations Claims Associate: 0-2 years of operations or insurance-related experience
  • Operations Claims Specialist: 2-3+ years of claims processing experience with demonstrated proficiency
  • Sr. Operations Claims Specialist: 3+ years of advanced claims experience, including complex or contestable claims
  • Sr. Operations Claims Analyst: 5+ years of experience with expertise in complex or contestable claims
  • Strong analytical, critical thinking, and problem-solving skills
  • High attention to detail with ability to manage multiple priorities
  • Ability to balance accuracy and efficiency in a fast-paced environment
  • Strong written and verbal communication skills, including handling sensitive situations with empathy
  • Ability to work both independently and collaboratively

What makes you stand out:
  • Experience with life insurance and/or annuity claims
  • Experience handling contestable claims or investigations
  • Experience with training, mentoring, or coaching

Education Requirements:
  • Bachelor's degree or equivalent combination of education and experience

Level Differentiation & Compensation:
Compensation will vary depending on level, experience, and qualifications, and location.
Operations Claims Associate
  • Entry-level role focused on developing foundational claims knowledge and skills
  • Omaha Compensation: $24 - $26/hr.
  • Charlotte Compensation: $25 - $27/hr.

Operations Claims Specialist
  • Independently performs advanced claims transactions and meets performance expectations
  • Omaha Compensation: $26 - $28/hr.
  • Charlotte Compensation: $27 - $29/hr.

Sr. Operations Claims Specialist
  • Handles complex or contestable claims and contributes to training, quality, and process improvement efforts
  • Omaha Compensation: $32 - $34
  • Charlotte Compensation: $33 - $36

Sr. Operations Claims Analyst
  • Serves as subject matter expert and leads complex investigations and cross-functional initiatives
  • Omaha Compensation: $39 - $41
  • Charlotte Compensation: $41 - $43

#LI-RB1
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.
$22.81 - $27.87
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, 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

You Can Be Who You Are
We are committed to a culture of diversity and inclusion that embraces the authenticity of all employees, partners and communities. We support all employees to thrive and achieve their fullest potential.
What's life like at Pacific Life? Visit Instagram.com/lifeatpacificlife
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.
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About Pacific Life

Sourced by ZipRecruiter

When you purchase life insurance and retirement solutions, you're buying a promise. A promise that today, tomorrow or ten years from now, we'll be there. For more than 150 years, our clients have trusted Pacific Life to protect what matters most to them - their families, their businesses, their futures.

Industry

Finance and insurance

Company size

1,001 - 5,000 Employees

Headquarters location

Newport Beach, CA, US

Year founded

1868

Social media

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