Claims Consultant

Trustmark
US - Maine - Augusta
January 18, 2025

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.

Responsible for reviewing and processing claims including, identifying irregularities and reviewing for accuracy, and completeness. Must comply with policy provisions and appropriate state and federal laws. Claim types include Wellness, Hospital Indemnity, Accident, Life, Long-Term Care (LTC), Disability and Critical Care.

Key Accountabilities

Identifies claims that need additional reviews, initiates and implements the appropriate reviews. Initiates independent analysis of claims that need additional review.
Manages active claims while adhering to department time service standards with quality performance.
Gathers and reviews data from different sources; make recommendations and decisions to be reviewed by trainer/leader.
Manages more complex claim operational activities which may include Presidential and Department of Insurance Complaints, reviewing state and federal regulations for applicability to claims, state reporting, and developing letters and forms for departmental use.
Reviews and understands complex medical, financial records and legal documents.
Understands and utilizes various investigative tools.
Learns and develops an understanding of complex policies and associated claim handling process. Performs claims handling processes and procedures related to less complex Life, LTC, Disability, Critical Care, Accident, Hospital Indemnity and Wellness claims.

Minimum Requirements

High School Diploma or GED with 6 years of related experience; or Bachelor's Degree with 0 - 2 years of related experience.

Brand: Trustmark

Come join a team at Trustmark that will not only utilize your current skills but will enhance them as well. Trustmark benefits include 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 the fourth consecutive year we were selected as a Top Workplace by the Chicago Tribune. The award is based exclusively on Trustmark associate responses to an anonymous survey. The survey measured 15 key drivers of engaged cultures that are critical to the success of an organization.

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

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.

Introduce yourself to our recruiters and we'll get in touch if there's a role that seems like a good match.

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.

Read the full job description and apply online on the recuiter's web-site

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