Senior Claims Manager

Trustmark; Boise (ID); Remote; USD 72,000 - 103,000; Full time

Benefits offered by this job

Health/dental/vision

Life insurance

FSA and HSA

401(k) plan

Employee Assistance Program

Back-up Care for Children

Adults and Elders

Wellness program

Job summary

Trustmark seeks a senior claims operations leader to oversee the claims processing organization, ensuring timely and accurate adjudication in line with government regulations. You will develop policies to maximize payment accuracy and lead cross-functional initiatives across the department.

You will analyze workflow, drive cost-effective process improvements, and mentor staff while managing multiple parallel projects and maintaining SLA adherence.

Qualifications

• Experience leading a claims processing team with oversight of end-to-end workflows.
• Ability to analyze trends and implement cost-effective process improvements.
• Strong knowledge of regulatory requirements and industry standards.

Responsibilities

• Oversee a claims processing organization and ensure timely, compliant payments.
• Develop adjudication policies and procedures to maximize accuracy.
• Evaluate activities for cost-effectiveness and lead improvement initiatives.
• Lead cross-functional teams and act as claims SME across projects.
• Support training and rollout of new processes and systems.

Skills

Leadership

Process improvement

Regulatory compliance

Staffing planning

Education

Bachelor's degree

High School Diploma or GED with related experience

Job description

Remote

Remote

Full time

106804

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

• Health/dental/vision
• life insurance
• FSA and HSA
• 401(k) plan
• Employee Assistant Program
• Back-up Care for Children
• Adults and Elders
• many health and wellness initiatives
• We also offer a Wellness program that enables employees to participate in health initiatives to reduce their insurance premiums.

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.

Join a passionate and purpose-driven team of colleagues who contribute to Trustmark's mission of helping people increase wellbeing through better health and greater financial security. At Trustmark, you'll work collaboratively to transform lives and help people, communities and businesses thrive. Flourish in a culture where appreciation, mutual respect and trust are constants, not just for our customers but for ourselves.

When you join Trustmark, you become part of an organization that makes a positive difference in people's lives. You will play a vital role in delivering on our mission of helping people increase wellbeing through better health and greater financial security. Our customers tell us they simply appreciate the personal attention and knowledgeable service. Others tell us We've changed their lives.

At Trustmark, you'll be part of a close-knit team. You'll enjoy abundant opportunities to grow your career. That's why so many of our associates stay at Trustmark and thrive. Trustmark benefits from more than 100 years of experience but pairs that rich history with a palpable sense of optimism, growth and excitement for what's ahead - and beyond. This is a place where associates bring their whole selves to work each day. A place where you can be yourself. Whatever your beyond is, you can achieve it at Trustmark.