Since 1913, Trustmark has offered valuable employee benefits and remained true to a belief in staying close to the people it serves and in building long-lasting customer relationships. Today, more than 6,200 staff members are employed at Trustmark’s home office in Lake Forest, IL and its 46 regional and branch offices across the country and onsite at client locations nationwide. We offer a broad range of life, medical, dental, managed care, disability, critical illness and benefit administration products and services to employers representing more than 2 million total policyholders.

Trustmark is looking for an ASSOCIATE CLAIM REPRESENTATIVE to work in our Worcester, Massachusetts office.  In this position, you will be learning our claims handling process and procedures.  To be successful in this role, you must have strong organizational, time management and decision making skills.

SUMMARY:

Under direct supervision, learn and begin to develop a full understanding of the claims handling process and procedures. Make claim payments in accordance with policy provisions and in compliance with state and federal laws. Work closely with assigned Sr. Claim Consultant/Trainer for technical questions and Director for sign-off of letters and payments. Review claim file and make recommendations on the appropriate resources, claim actions and decisions appropriately as outlined in our claim philosophy and contracts.

RESPONSIBILITIES INCLUDE:     

• Develop, via training, a full understanding of the claims handling process and procedure.  Ability to review, recommend actions and process claims appropriately to support our claim philosophy in accordance with policy provisions and state and/or federal laws. 
• Seek on-the-job training input and advice from assigned Sr. Claim Consultant/Trainer and seek letter/payment authority through Director.
• Manage active claims, as assigned.
• Responsible to handle a given caseload while adhering to department time standards with quality performance. 
• Ability to gather and review data from different sources and make recommendations to be reviewed by trainer/leader and process decision.
• Identify claims that need additional reviews, initiate and implement the appropriate reviews under supervision. 
• Ability to review and understand medical and financial records.
• Understand and effectively utilize various investigative tools. 
• Ability to effectively communicate and explain contract definitions to insured both verbally and in writing.
• Provide outstanding customer service to insureds throughout their claim.
• Ability to participate in special projects and assignments in addition to effectively managing caseload.

QUALIFICATIONS:

• One year of prior claim experience required.
• Bachelor's degree OR related experience preferred.
• Proficiency in Word/Excel/Access is required.
• Insurance experience of 2-3 years is preferred.
• Professional designation encouraged such as CLU, ALHC,
• Ability to travel occasionally.
• Ability to work hours of Mon. & Tues.: 11:15 - 8:00 pm; Wed. & Thurs.: 11:30 - 8:00 pm and Fridays from 1:00 - 7:00 pm.
• Project management skills
• Good written/verbal communication skills.
• Strong attention to detail.

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

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability status, protected veteran status, or any other characteristic protected by law. We are a VEVRAA Federal Contractor.