For more than four decades, Trustmark Health Benefits has crafted integrated, flexible, and tailored employer health plan designs that seamlessly meet specific business needs and delight members. Each of our offices around the country is managed locally, by industry veterans who understand the dynamics of the markets they serve. Our responsive and empathetic service teams provide the highest level of support for employers and members. Our local expertise and service represents our national strength. We are an independently operated subsidiary of Trustmark Mutual Holding Company.
The Care Champion provides telephonic services to our Clients' employees (and their immediate family) to assist in: understanding, navigating, and getting the best value out of the healthcare, wellness and employee incentive programs provided by the Client. In addition the Care Champion will assist in navigating the healthcare system as they seek health and wellness services, interact with providers and insurers, find useful community resources and reduce the caller's stress as well as saving time and costs.
Provide tier II level support for client advocacy cases that require one or multiple interactions with the client, providers, insurers, and community resources providing, but not limited to, the following services and support:
Assisting members with complex issues by researching and navigating through internal and external resources through resolution. Assist with preparation for doctor visits by ensuring members know what questions to ask, what to remember to bring (pre-visit form(s), insurance cards, etc.) and referral process. Assist and support Members in navigating the healthcare system as they seek health and wellness services and interact with providers and insurers. Assist with insurance claims and billing issues – investigate and help solve escalated issues. Provide guidance, advice, and support for health insurance appeals. Stay in contact with the Member through the resolution of their problem. Facilitate and coordinate delivery of healthcare related home and community-based services. Educate Members regarding healthcare issues (i.e. hospice care, clinical trials, Centers of Medical Excellence, caregiver issues for Seniors/disabled). Identify and locate physicians, dentists, hospitals, wellness services, senior care and behavioral health services; assist with referrals and appointments. Explore payment options to assist with financial circumstances. Help members understand the financial implications of their choices. (ex. In/out of network, higher/lower cost providers, retail/mail prescriptions). Answer incoming calls and e-mails from the Client's employees and their covered family members and identify their immediate needs and determine the appropriate resolution action(s):
Nurse Line intake Accurately respond to benefit inquiries (e.g. medical, dental, life, STD, LTD). Educating members on their plan selection options (e.g., consumer-driven health plans, FSAs, HSA's), provider selection, qualifying life events and the open enrollment process. Assisting members with understanding, navigating through and obtaining the maximum value of their healthcare and wellness benefits. Connect members with healthcare and wellness resources. Informing members of their healthcare and/or wellness options and information, to resolve question or issue at hand. Accurate and timely call/case documentation in appropriate systems' applications. Act as subject matter expert of assigned client by:
Understanding clients plan structure, wellness programs, websites and resources. Supporting internal team questions regarding assigned client and researching answers as needed. Maintaining client information in the call center software and Connect Care drive upon receipt of updates. Communicating changes to client benefits and program to internal team via email. Assisting with client training for new hires. QUALIFICATIONS:
Associates Degree or relevant industry experience. Minimum of 3 years of medical clerical experience, health benefits, or insurance coordination; or equivalent combination of education and experience required.. Demonstrated experience with managing (research, problem solving, organizing, tracking, reporting) client advocacy cases that require one or multiple interactions with the client, providers, insurers, and community resources. Ability to effectively organize and prioritize work demands in a dynamic, fast-paced environment with minimal supervision. Ability to continuously display a positive attitude and follow directions. Possess excellent customer service skills including proper grammar, tonalities and clear diction. Proficient in Microsoft Office Suite, data entry and electronic mail applications. Excellent written and verbal communication skills, including the ability to adapt communication style to persons representing diverse personal, professional, cultural, and socio-economic backgrounds. Must be able to work a flexible 37.5 hour work week in a 24/7 call center environment- some 3rd shift, evenings and weekends, and holidays will be required. Ability to sit and use the phone for long periods of time. Previous customer service and/or call center experience. Bilingual English/Spanish preferred. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, age, or disability
Trustmark is pleased to have earned recognition from the Chicago Tribune as a Chicago Top Workplaces 2020 Award winner.
Required Skills Required Experience
