Jobs Companies HealthFitness Senior Claims Manager

About this Senior Claims Manager role at HealthFitness

HealthFitness · Remote · Remote

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.

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.

Trustmark is committed to leveraging the talent of a diverse workforce to create great opportunities for our people and our business.  We are an equal opportunity employer, including disability and protected veteran status.

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About HealthFitness

We’re a nationwide team of more than 2,400 professionals who believe in the power of health and fitness — and creating opportunities for others to believe as well. We are dedicated to improving the health and wellbeing of those we serve and consider ourselves lucky to inspire, motivate and engage over 1 million participants across our 135 clients, from corporations to health systems to colleges and universities. We started in 1975 as Fitness Systems. Over the years we expanded our services and capabilities to offer injury prevention and treatment and wellness services, so that we can truly care for the whole person. Today, we are HealthFitness and we’re backed by Trustmark, a benefits compan

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