LTD Claims Strategist — Impactful, Policy-Savvy Expert

pacificlife; United States; Remote; USD 90,000 - 120,000; Full time

Job summary

Pacific Life seeks a Senior Long Term Disability Claims Specialist for the Work Force Benefits Division. You will manage complex LTD claims, collaborate with clinical and vocational partners, and drive process improvements while ensuring compliant, empathetic claimant interactions.

You will mentor teammates, handle sensitive conversations, and interpret policy provisions and ERISA regulations to ensure accurate outcomes.

Qualifications

• Bachelor's degree or equivalent work experience required.
• 5+ years of Long Term Disability claims experience.
• Ability to independently manage a full caseload with limited oversight.
• Strong communication with claimants, employers, providers, and internal partners.
• Customer-focused with proactive, solutions-oriented problem solving.
• Demonstrated empathy and professionalism in sensitive conversations.
• Ability to interpret policy provisions, contractual language, and regulatory requirements.
• Advanced knowledge of ERISA and related federal/state requirements.
• Knowledge of Pacific Life's Workforce Benefits platforms and claims systems.

Responsibilities

• Manage a diverse and complex caseload of LTD claims through intake to resolution, ensuring timely and fair decisions.
• Collaborate with clinical and vocational partners to develop RTW strategies and determine eligibility and durations.
• Serve as a subject matter expert on LTD claim practices and help refine internal procedures and workflows.
• Ensure detailed documentation of decisions and communications with claimants, employers, and stakeholders.
• Mentor onboarding of new team members and share expertise within the team.
• Coordinate cross-functionally with Compliance, Legal, Intake/Admin, Clinical and Vocational Services.
• Identify process gaps and contribute to continuous improvement initiatives.
• Demonstrate adaptability to changing priorities and regulatory requirements.

Skills

Claims management

Communication

Empathy

Analytical thinking

Education

Bachelor's degree or equivalent

Tools

ERISA knowledge

Claims systems

Workflow tools

Job description

Pacific Life seeks a Senior Long Term Disability Claims Specialist for the Work Force Benefits Division. You will manage complex LTD claims, collaborate with clinical and vocational partners, and drive process improvements while ensuring compliant, empathetic claimant interactions.

You will mentor teammates, handle sensitive conversations, and interpret policy provisions and ERISA regulations to ensure accurate outcomes.