Senior Long Term Disability Claims Specialist

🔥 8 minutes ago

🇺🇸 United States – Remote

💵 $69.4k - $84.8k / year

⏰ Full Time

🟠 Senior

📋 Claims Specialist

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Pacific Life

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1868

💸 Finance

🛡️ Insurance

Finance • Insurance • Retirement

Pacific Life is a financial services company that offers a wide range of retirement and life insurance solutions. It provides annuities, life insurance, and workforce benefits designed to help individuals and institutions secure their financial futures. With nearly 160 years of experience and a strong commitment to customer trust, Pacific Life focuses on delivering stability and protection for its clients' families, businesses, and future goals. The company is dedicated to creating meaningful future outcomes through corporate social responsibility and innovative products.

📋 Description

• Manage a diverse and complex caseload of Long Term Disability claims from initial intake through resolution • Make timely, fair, and accurate claim decisions using sound judgment and policy provisions • Collaborate with clinical and vocational partners to develop return-to-work strategies and determine benefit eligibility and durations • Serve as a subject matter expert on Long Term Disability claim practices • Consult on best practices and contribute to internal procedures, workflows, and system requirements • Apply disability contract provisions, exclusions, riders, waivers, and regulatory and statutory requirements • Document decisions and interactions accurately and communicate with claimants, employers, and internal stakeholders • Mentor and support onboarding of new team members • Collaborate with Compliance, Legal, Intake/Admin, Clinical and Vocational Services, and other business units • Identify process gaps and contribute to continuous improvement and enterprise initiatives • Adapt to changing priorities, business needs, and regulatory requirements • Maintain confidentiality, professionalism, and integrity in claim-related activities • Perform other duties as assigned

🎯 Requirements

• Bachelor’s degree or equivalent work experience preferred • 5+ years of Long Term Disability claims experience required • Experience managing complex and high-risk cases preferred • Ability to independently manage a full caseload and make sound decisions with limited oversight • Strong communication skills for engaging with claimants, employers, providers, and internal partners • Customer-focused, proactive, solutions-oriented approach to problem solving • Ability to handle sensitive and difficult conversations with empathy and professionalism • Ability to interpret and apply policy provisions, contractual language, and regulatory requirements • Advanced knowledge of ERISA and related federal and state regulatory requirements • Ability to apply guidelines to complex claim scenarios and ensure consistent, compliant outcomes • Ability to develop and maintain strong knowledge of Pacific Life’s Workforce Benefits platforms, claims administration systems, and workflow tools • Detail-oriented with balanced, objective decision-making and a high degree of integrity and accountability • Advanced analytical and critical thinking skills • Ability to evaluate complex medical, vocational, and financial information • Ability to work independently and serve as a resource and informal mentor • Ability to contribute to process improvements and best practices • Strong organizational and time management skills • Ability to prioritize competing demands and adapt quickly in a fast-paced, changing environment

🏖️ Benefits

• Medical, Dental, Vision, and Wellbeing Reimbursement Account for employees and eligible dependents • Paid Time Off • Holiday Schedules • Financial Planning Time Off • Paid Parental Leave • Adoption Assistance Program • Competitive 401k savings plan with company match • Additional 401k contribution regardless of participation • Flexible benefits that can be tailored to individual needs