Claims Manager

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🔥 6 minutes ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $70.3k - $94.1k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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Trillium Health Resources

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

Trillium Health Resources is a leading specialty care manager (LME/MCO) for individuals with serious behavioral health, intellectual/developmental disabilities, and traumatic brain injury in North Carolina. The organization is committed to investing in the health and well-being of the communities it serves, providing services such as preventive health screenings, crisis intervention, and tailored care management. Trillium focuses on enhancing access to mental health and substance use services for its members and ensuring support for vulnerable populations.

📋 Description

• Oversee the accurate and efficient processing of all healthcare claims, • Ensure the integrity of claim data and delivering timely reporting and analysis. • Manage claim-related inquiries and coordinate claim appeals, • Work collaboratively across multiple internal teams to resolve provider issues. • Generate and analyze claims payment reports to determine problems. • Complete analysis, research, and corrections in a timely manner to ensure provider payment. • Assist in developing and maintaining claim processing procedures.

🎯 Requirements

• Associate’s degree and three (3) years of experience with extensive claims filing and data reporting; OR Bachelor’s degree and a minimum of one (1) year of experience with extensive claims filing and data reporting; OR Equivalent combination of education/experience. • Must have a valid driver’s license. • Must reside within North Carolina. • Must be able to travel within catchment as required. • Preferred: Advanced degree • Preferred: Supervisory experience of two (2) or more employees • Preferred: Physical Health claims experience

🏖️ Benefits

• Health Insurance with no premium for employee coverage • Flexible Spending Accounts • 24 days of Paid Time Off (PTO) plus 12 paid holidays in your first year • NC Local Government Retirement Pension (defined-benefit plan) • 401k with 5% employer match and immediate vesting • Public Service Loan Forgiveness (PSLF) qualifying employer • Quarterly stipend for remote work supplies