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Senior Claims Manager

Role overview

Qualifications

  • Bachelor's Degree with 4-6 years of related experience
  • High School Diploma or GED with 6-8 years related experience

Responsibilities

  • Oversee a claims processing organization and ensure compliance with government regulations
  • Develop claims adjudication policies and procedures to maximize accuracy of claims payments
  • Evaluate claims activities for cost-effectiveness and implement process improvements
  • Manage overall operations of the department, including compliance with policies and service level agreements

Key facts

Hard skills

Other skills

  • Communication
  • Teamwork
  • Problem Solving

About the company

Trustmark logo

Trustmark

Insurance

Trustmark is a national employee benefits company offering specialized expertise in voluntary benefits, self-funded health benefit plan design and administration, and employee health and fitness programs that drive results through human and virtual connection. Trustmark offers employers access to benefit options usually reserved for large companies, combined with the personal service you’d expect from a small company. Trustmark’s commitment to building long-term, trusted relationships helps people and businesses thrive. • Trustmark Voluntary Benefits provides valuable life, hospital, accident, disability and critical illness insurance designed to fit changing needs based on life stage or financial priorities. Trustmark helps educate employees and provides resources to help communicate the value of benefits and other important company initiatives. To learn more, visit TrustmarkVB.com. • Trustmark Health Benefits is a total benefits solution for mid-sized and large self-funded employers. As one of the nation’s largest independent benefits administrators, we help our clients manage costs without compromising care by offering innovative solutions, flexibility, and complete data transparency for our clients. To learn more, visit TrustmarkHB.com. • Trustmark Small Business Benefits® level-funded solutions allow small to mid-size employers to provide affordable health benefits to employees. Available to groups with five or more employees along with simplified underwriting for 51 or more enrolled employees, our comprehensive self-funded plan designs and services help empower clients to be smarter healthcare consumers. To learn more, visit TrustmarkSB.com. • HealthFitness is a comprehensive wellbeing provider that delivers wellness, fitness and injury prevention programs. To learn more, visit Healthfitness.com.

Company details

Company typeLarge
IndustryInsurance
Company size1001 - 5000

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Job description

Trustmark’s mission is to improve wellbeing – for everyone. It is a mission grounded in a belief in equality and born from our caring culture. It is a culture we can only realize by building trust. Trust established by ensuring associates feel respected, valued and heard. At Trustmark, you’ll work collaboratively to transform lives and help people, communities and businesses thrive. Flourish in a culture of diversity and inclusion where appreciation, mutual respect and trust are constants, not just for our customers but for ourselves. At Trustmark, we have a commitment to welcoming people, no matter their background, identity or experience, to a workplace where they feel safe being their whole, authentic selves. A workplace made up of diverse, empowered individuals that allows ideas to thrive and enables us to bring the best to our colleagues, clients and communities.

About the role

Responsible for overseeing a claims processing organization. Ensures claims are processed in a timely manner in accordance and compliant with government regulations. Develops claims adjudication policies and procedures that maximize the accuracy of claims payments. Evaluates claims activities to assess cost-effectiveness and implement process improvement initiatives. 

Manages the overall operations of the department, including individual contributors and supervisors, ensuring compliance with company policies, industry regulations, and service level agreements.  Serves as lead for claim processes, regulations and industry standard projects.
Analyzes workflow and determine actions needed to meet current and future production/ staffing needs. Works with cross-functional teams and serving as claims subject matter expert.  Identifies trends, develops, and implements plans to improve results and processes.
Researches, investigates and responds to escalated service issues with internal and external customers.  Takes necessary corrective action including root cause analysis when appropriate. Provides sign-off approval of complex or high-dollar claims.
Supports training and implementation of new processes and systems required to manage administration of policy changes.
Participates in or leads multiple projects by assigning resources, working on timelines and implementing schedule to complete project timeline.

Minimum Requirement:

Bachelor's Degree with 4-6 years of related experience OR High School Diploma or GED with 6-8 years related experience.

The compensation range for this role is (based on the corporate location in Lake Forest, Illinois):

$71,520.40 - $103,307.70 per year

The final salary offer will be determined based on factors such as location, qualifications, experience, skill set, and other relevant factors. This position may also be eligible for bonus. We understand that compensation is an important factor when considering a new opportunity, and we strive to provide a competitive salary within the market.

Brand: Trustmark

In addition to compensation, we offer a comprehensive benefits package that includes: Health/dental/vision, life insurance, FSA and HSA, 401(k) plan, Employee Assistant Program, Back-up Care for Children, Adults and Elders and many health and wellness initiatives. We also offer a Wellness program that enables employees to participate in health initiatives to reduce their insurance premiums.  For questions about compensation and benefits, please speak to the Recruiter if you decide to apply and are selected for an interview.

Trustmark is committed to leveraging the talent of a diverse workforce to create great opportunities for our people and our business.  We are an equal opportunity employer, including disability and protected veteran status.

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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