[Hiring] Senior Long Term Disability Claims Specialist @Pacific Life

Role Description

We’re actively seeking a talented Sr Long Term Disability Claims Specialist to join our growing Work Force Benefits Division. As a Senior Long Term Disability Claims Consultant you'll move Pacific Life and your career forward by developing and refining claims processes, ensuring compliance with evolving regulations, and helping deliver a best-in-class, empathetic claims experience.

• Manage a diverse and often complex caseload of LTD claims from initial intake through resolution, ensuring timely, fair, and accurate decisions using sound judgment and adherence to policy provisions.
• Collaborate with clinical and vocational partners to develop effective RTW strategies and determine appropriate benefit eligibility and durations.
• Serve as a subject matter expert on LTD claim practices, consulting on best practices and contributing to the design and refinement of internal procedures, workflows, and system requirements.
• Leverage a deep understanding of disability contract provisions, exclusions, riders, waivers, and applicable regulatory and statutory requirements (e.g., FMLA, ERISA, HIPAA).
• Ensure detailed and accurate documentation of all decisions and interactions, and communicate clearly with claimants, employers, and internal stakeholders.
• Mentor and support onboarding of new team members; share expertise and foster knowledge growth within the team.
• Collaborate cross-functionally with Compliance, Legal, Intake/Admin, Clinical and Vocational Services, and other business units to deliver a coordinated and compliant claims experience.
• Proactively identify process gaps or opportunities and contribute to continuous improvement efforts and enterprise initiatives.
• 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.

Qualifications

• Bachelor’s degree or equivalent work experience preferred.
• 5+ years of Long Term Disability claims experience required, including management of complex and high-risk cases preferred.
• Demonstrated ability to independently manage a full caseload and make sound decisions with limited oversight.
• Strong communication skills with the ability to effectively engage with claimants, employers, providers, and internal partners.
• Customer-focused with a proactive, solutions-oriented approach to problem solving.
• Proven ability to handle sensitive and difficult conversations with empathy and professionalism.
• Ability to interpret and apply policy provisions, contractual language, and regulatory requirements accurately and consistently.
• Advanced knowledge of ERISA and related federal and state regulatory requirements, with demonstrated ability to apply guidelines to complex claim scenarios and ensure consistent, compliant outcomes.
• Will develop and maintain strong knowledge of Pacific Life’s Workforce Benefits platforms, including claims administration systems and workflow tools.

Requirements

• Detail-oriented with the ability to make balanced, objective decisions with a high degree of integrity and accountability.
• Advanced analytical and critical thinking skills, including the ability to evaluate complex medical, vocational, and financial information.
• Ability to work independently while also serving as a resource and informal mentor to less experienced team members.
• Demonstrates ownership of outcomes and contributes to process improvements and best practices.
• Highly organized with strong time management skills and the ability to prioritize competing demands.
• Ability to manage multiple priorities and adapt quickly in a fast-paced, changing environment.

Benefits

• 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.