Pacific Life
Pacific Life
Pacific Life este o companie de servicii financiare și asigurări axată pe sprijinirea persoanelor, familiilor, întreprinderilor și instituțiilor în pregătirea pentru viitor. Oferta sa include asigurări de viață, anuități, soluții pentru pensionare și beneficii pentru angajați. Fondată în 1868, compania îmbină experiența îndelungată în protecția financiară cu accentul pe dezvoltarea unor produse care susțin siguranța financiară pe termen lung și rezultate semnificative pentru clienții săi.

Senior Long-Term Disability Claims Specialist

Manage complex long-term disability claims for Pacific Life Insurance Company, from initial review through resolution. Make compliant decisions, develop return-to-work strategies, and support a considerate claimant experience.

Descriere

  • Manage complex long-term disability claims from initial intake through resolution.
  • Make timely, fair, and accurate decisions based on sound judgment and policy terms.
  • Work with clinical and vocational partners to plan return-to-work strategies and determine benefit eligibility and duration.
  • Act as a subject matter expert on long-term disability claim practices.
  • Advise on best practices and help shape internal procedures, workflows, and system requirements.
  • Apply disability contract terms, exclusions, riders, waivers, and applicable regulatory and statutory requirements.
  • Accurately document decisions and interactions, and communicate with claimants, employers, and internal stakeholders.
  • Mentor colleagues and support onboarding for new team members.
  • Partner with Compliance, Legal, Intake and Administration, Clinical and Vocational Services, and other business units.
  • Spot process gaps and contribute to continuous improvement and enterprise initiatives.
  • Respond to changing priorities, business needs, and regulatory requirements.
  • Protect confidentiality and uphold professionalism and integrity in claims work.
  • Carry out other duties as assigned.

Cerințe

  • Bachelor’s degree or equivalent work experience preferred.
  • At least 5 years of long-term disability claims experience required.
  • Experience handling complex, high-risk cases preferred.
  • Able to manage a full caseload independently and make sound decisions with limited oversight.
  • Strong communication skills for working with claimants, employers, providers, and internal partners.
  • Customer-focused, proactive, and solutions-oriented approach to problem solving.
  • Able to handle sensitive and difficult conversations with empathy and professionalism.
  • Able to interpret and apply policy terms, contract language, and regulatory requirements.
  • Advanced knowledge of ERISA and related federal and state regulatory requirements.
  • Able to apply guidelines to complex claims and deliver consistent, compliant outcomes.
  • Able to build and maintain strong knowledge of Pacific Life’s Workforce Benefits platforms, claims administration systems, and workflow tools.
  • Detail-oriented, with balanced and objective judgment, integrity, and accountability.
  • Advanced analytical and critical thinking skills.
  • Able to assess complex medical, vocational, and financial information.
  • Able to work independently and act as a resource and informal mentor.
  • Able to contribute to process improvements and best practices.
  • Strong organizational and time management skills.
  • Able to prioritize competing demands and adapt quickly in a fast-paced, changing environment.

Beneficii

  • 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 401(k) savings plan with company match.
  • Additional 401(k) contribution regardless of participation.
  • Flexible benefits that can be tailored to individual needs.

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