Senior Claims Specialist - Short Term Disability

Pacific Life

4d • Remote

About The Position

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 Senior Claims Specialist - Short Term Disability join our Workforce Benefits Team in Omaha, NE or (remote) in Chattanooga, TN. As a Senior Claims Specialist - Short Term Disability, you’ll move Pacific Life, and your career, forward by leading the end-to-end adjudication of complex Short Term Disability claims, partnering closely with clinical and vocational resources to support claim decision-making and help employees in their return-to-work (RTW) journey. You will play an instrumental part in developing and refining claims processes, ensuring compliance with evolving regulations, and helping deliver a best-in-class, empathetic claims experience. You will fill an existing role that sits on a team in the Workforce Benefits Division. You'll play an instrumental part in developing and refining claims processes, ensuring compliance with evolving regulations, and helping deliver a best-in-class, empathetic claims experience. This position combines hands-on case management with leadership and mentorship responsibilities. As a trusted resource and role model, you’ll elevate team performance, ensure consistency in service delivery, and uphold Pacific Life’s core values of integrity, innovation, and accountability.

Requirements

• College degree or equivalent experience preferred.
• Minimum 5 years of experience handling Short Term Disability claims
• Strong understanding of Short term Disability claim adjudication and relevant federal/state regulations (e.g., FMLA, ERISA, HIPAA, ADA).
• Experience partnering with clinical/vocational professionals to support RTW efforts and complex decisioning.
• Effective verbal and written communication skills with the ability to explain complex decisions clearly and empathetically.
• Demonstrated problem-solving and analytical skills with a customer-first mindset.
• Highly organized and detail-oriented with the ability to manage competing priorities.
• Proven ability to mentor peers and support a collaborative team environment.
• Proficiency with claims administration platforms and workflow/documentation tools.
• Demonstrated ability to work independently and exercise sound judgment.
• Growth mindset with a commitment to continuous learning and improvement.
• Strong time management and the ability to thrive in a fast-paced, evolving environment.
• Experience supporting cross-functional or enterprise initiatives and change management efforts.

Nice To Haves

• Experience with Long Term Disability and/or absence management

Responsibilities

• Manage a diverse and often complex caseload of STD (Short Term Disability) 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 STD 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.

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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 1,001-5,000 employees