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Claims Analyst - Customer Service (20181375)

Company: Trustmark Insurance
Location: Worcester
Posted on: January 15, 2019

Job Description:

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. We are looking for a Claims Analyst in our Worcester, Massachusetts office working in our Voluntary Benefits division. In this position, you will mainly focus on reviewing and making claim payments for lower indemnity claims and handling calls and assisting claimants and others on any customer service-related issues. The ideal candidate should have excellent time management skills, strong attention to detail and possess excellent verbal and written communication skills. Summary: To learn and understand the claims handling process and procedures related to Worksite Cancer Critical Illness (CA/CI) and Accident or Life claims. Make claim payments in accordance with the policy provisions and appropriate state and federal laws, review and make recommendations on the appropriate resources to utilize in claim investigations and to handle claims appropriately as outlined in our claim philosophy. RESPONSIBILITIES INCLUDE: Claims Management: * Learn, fully understand and perform the claims handling process and procedures related to CA/CI and Accident products. * Process all Life claims. * Handle claims appropriately to support our claim philosophy in accordance with policy provisions and appropriate state and federal laws. * Responsible for handling a given caseload while adhering to department time service standards with quality performance. * Ability to identify claims that need additional reviews and implement appropriate reviews. * Manage high volume of claims and phone calls and explain contract definitions to insureds both verbally and in writing. * Compose letters to insureds. * Work well on phones and display empathy when necessary. * Ability to review and understand medical records. Mail Handling: * Open all incoming mail, faxes and emails and perform research on any questionable mail and research any questionable mail via CIA, Claim Central II or through discussion with management, as needed. * Enter all mail received into Claims Central II within department time service standards. * Build knowledge of systems, lines of business, forms, etc. to allow ease in identification of mailing being received. * Identify mail as Accident and determine appropriate date of claim(s). * Order worksheets necessary to open claims and match worksheets to appropriate claim. * Deliver all claims to appropriate Benefit Adjustor for processing. * Ensure team members are kept up to date on dating of work being processed. QUALIFICATIONS: The successful candidate will demonstrate reliability, good attendance and punctuality, and have the ability to meet production and quality standards. Other qualifications include: * Must be able to work Monday ? Thursday from 11:15 ? 8:00 pm and Fridays from 1:00-7:00 pm. * Must have at least 1 year of corporate office experience. * Proficiency in database input. * Insurance or claims experience strongly preferred. * Proficiency in MS Word and Excel required. * Very good verbal/written communication skills * Excellent time management and organizations skills required. * Excellent phone skills required. 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.SDL2017

Keywords: Trustmark Insurance, Worcester , Claims Analyst - Customer Service (20181375), Hospitality & Tourism , Worcester, Massachusetts

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