Senior Claims Manager

🔥 15 hours ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $71.5k - $103.3k / year

⏰ Full Time

🟠 Senior

👔 Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Trustmark

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1913

💼 Consulting

🏥 Healthcare

🛡️ Insurance

Consulting • Healthcare • Insurance

Trustmark is a benefits company that provides voluntary insurance products—including life, accident, critical illness, disability, and hospital coverage—alongside small-business level-funded health solutions and employer wellness services through its HealthFitness division. With more than 100 years of experience, Trustmark serves individuals, employers, brokers and providers, emphasizing personalized service, community involvement, and financial strength (AM Best A rating).

📋 Description

• Oversee a claims processing organization • Ensure claims are processed timely and in compliance with government regulations • Develop claims adjudication policies and procedures to maximize claims payment accuracy • Evaluate claims activities for cost-effectiveness and implement process improvement initiatives • Manage department operations, including individual contributors and supervisors • Ensure compliance with company policies, industry regulations, and service level agreements • Serve as lead for claim processes, regulations, and industry standard projects • Analyze workflow and determine actions needed to meet current and future production and staffing needs • Work with cross-functional teams as a claims subject matter expert • Identify trends and develop and implement plans to improve results and processes • Research, investigate, and respond to escalated service issues with internal and external customers • Take corrective action, including root cause analysis when appropriate • Provide sign-off approval of complex or high-dollar claims • Support training and implementation of new processes and systems required to manage policy changes • Participate in or lead multiple projects by assigning resources, managing timelines, and implementing schedules

🎯 Requirements

• Bachelor's Degree with 4-6 years of related experience OR High School Diploma or GED with 6-8 years related experience • Knowledge of claims processing, adjudication policies and procedures, government regulations, industry regulations, and service level agreements • Experience analyzing workflow and staffing needs • Experience identifying trends and implementing process improvements • Experience researching, investigating, and responding to escalated service issues • Experience conducting root cause analysis • Experience approving complex or high-dollar claims • Experience supporting training and implementing new processes and systems • Experience leading or participating in multiple projects

🏖️ Benefits

• Health/dental/vision insurance • Life insurance • FSA and HSA • 401(k) plan • Employee Assistant Program • Back-up Care for Children, Adults and Elders • Health and wellness initiatives • Wellness program enabling employees to participate in health initiatives to reduce insurance premiums • Bonus eligibility