Senior Claims Specialist - Short Term Disability

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. 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 Newport Beach, CA, 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.

How you'll help move us forward:

• 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.

The experience you bring:

• 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.

What makes you stand out:

* Experience with Long Term Disability and/or absence management

#LI-KB1

You can be who you are.

People come first here. We're committed to an inclusive workforce. Learn more about how we create a welcoming work environment at www.pacificlife.com. What's life like at Pacific Life? Visit Instagram.com/lifeatpacificlife.

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.

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

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.