Trustmark · 6 hours ago

Claims Specialist

United States

Full-time

Remote

Entry, Mid Level

4+ years exp

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Responsibilities

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.

Demonstrates strong understanding and performs claims handling processes and procedures related to Wellness, Hospital and Accident claims.

Manages high volume of non-routine claims and phone calls.

Explains more complex contract definitions to insureds both verbally and in writing.

Processes claim operational activities which may include tax reporting, journal vouchers, overpayments or special investigation duties.

Reviews and understands non-routine medical records.

Qualification

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Claims handling processesWellness claimsHospital claimsAccident claimsNon-routine medical recordsTax reportingJournal vouchersSpecial investigation duties