Senior Long Term Disability Claims Specialist

Pacific Life•Charlotte, NC

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. 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 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 you career forward by developing and refining claims processes, ensuring compliance with evolving regulations, and helping deliver a best-in-class, empathetic claims experience.

Requirements

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 Workforce Benefits platforms, including claims administration systems and workflow tools

Nice To Haves

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

Responsibilities

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.

Benefits

Medical
Dental
Vision
Wellbeing Reimbursement Account
Paid Time Off
Holiday Schedules
Financial Planning Time Off
Paid Parental Leave
Adoption Assistance Program
Competitive 401k savings plan with company match and an additional contribution regardless of participation