At The Trustmark Companies we help people thrive. We provide products and personalized attention that engage and inspire people to maximize their health potential. We offer employee benefits customized to fit each unique business need or life circumstance. It all revolves around our belief that better health and greater financial security increase overall well-being. And with well-being comes peace of mind. Peace of mind to focus on work and family and everything else that’s important in life. Peace of mind to thrive.

SUMMARY:  In this position, you will handle higher level functions associated with claims processing. You must have good working knowledge of the claim processing platform(s) used for the body of work assigned. You must possess strong analytical, organizational, and letter writing skills and have the ability to communicate effectively with others, both verbally, and in writing. The position also requires good customer service skills and the ability to meet deadlines. 

RESPONSIBILITIES INCLUDE:     

CLAIMS MANAGEMENT:

• Handle Grievances and Appeals, adhering to compliance regulations and deadlines
• Liaison for Ancillary Departments and Outsourcing Business Partner such as Law, LCM, Managed Care, Medical Directors, and Caliber Point
• Handle Pre-Determination of Benefit Requests in accordance with claim practices, meeting production & quality standards.
• Handle adjustments including recovering funds and voiding checks if necessary in accordance with claim practices, meeting production & quality standards.
• Identify and assist in one touch resolution of claim & eligibility questions and issues.
• Adjudicate claims, either at first level, or at over-limit level, adhering to production & quality standards.
• Handle correspondence from customers and providers, both written and verbally.
• Run claim reports in various systems as requested by internal and external customers.
• Participate in project meetings and committees as assigned.
• Other duties as needed/assigned.

QUALIFICATIONS:

• A minimum of 2 years of prior claims experience is required.
• Working knowledge of Operating System(s)used by the Claims Area preferred.
• 2-4 year degree preferred.
• Excellent written and verbal communication skills required.
• Must have strong analytical organization and writing skills.

Come join Trustmark! Join a team that will not only utilize your current skills, but will enhance them as well. Trustmark benefits include medical/dental/life insurance, tuition reimbursement, competitive 401k plan, insurance education classes, health and wellness initiatives and more!

All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, age, or disability.

Required Skills Required Experience

Requirements:

• Minimum of 10 years of related experience, preferably in the relocation industry
• Bachelor Degree in Accounting or related field or equivalent experience
• Demonstrated leadership, technical, analytical and communication skills
• Articulate with good listening skills
• Solid working knowledge of MS Office, particularly Excel, Access and Outlook
• Knowledge of tax assistance calculations and payroll application
• Experience with payroll, accounts payable, and general bookkeeping
• Demonstrated initiative and creative problem-solving, working effectively under pressure
• Attention to detail, large and small and well-organized with excellent follow-up skills
• Solid working knowledge of the Tax Gross-up and Billing modules of the Equus GROW application.