Sr. Short Term Disability Specialist-1

Job Description:

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 (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.

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.

College degree or equivalent experience preferred. Minimum 3 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…