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.
