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 reviewing and processing claims including, identifying irregularities and reviewing for accuracy, and completeness. Must comply with policy provisions and appropriate state and federal laws. Claim types include Wellness, Hospital Indemnity, Accident, Life, Long-Term Care (LTC), Disability and Critical Care.Key Accountabilities
- Identifies claims that need additional reviews, initiates and implements the appropriate reviews. Initiates independent analysis of claims that need additional review.
- Manages active claims while adhering to department time service standards with quality performance.
- Gathers and reviews data from different sources; make recommendations and decisions to be reviewed by trainer/leader.
- Manages more complex claim operational activities which may include Presidential and Department of Insurance Complaints, reviewing state and federal regulations for applicability to claims, state reporting, and developing letters and forms for departmental use.
- Reviews and understands complex medical, financial records and legal documents.
- Understands and utilizes various investigative tools.
- Learns and develops an understanding of complex policies and associated claim handling process. Performs claims handling processes and procedures related to less complex Life, LTC, Disability, Critical Care, Accident, Hospital Indemnity and Wellness claims.
Minimum Requirements
- High School Diploma or GED with 6 years of related experience; or Bachelor’s Degree with 0 – 2 years of related experience.
The compensation range for this role is (based on the corporate location in Lake Forest, Illinois):
$62,947.30 - $90,923.65 per yearThe 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.
Skills Required
- High School Diploma or GED with 6 years related experience OR Bachelor's Degree with 0-2 years related experience
- Experience handling Life, Long‑Term Care, Disability, Critical Care, Accident, Hospital Indemnity, and Wellness claims
- Knowledge of policy provisions and applicable state and federal laws for claims adjudication
- Ability to review and interpret complex medical, financial, and legal records
- Experience using investigative tools and performing independent claims analysis
- Ability to manage claims to meet department time service standards and quality metrics
What We Do
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.
