Claims Relations Coordinator

🕒 June 12

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $54.1k - $67.2k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

Apply Now

Find Similar Remote Jobs

Receive Emails For Remote Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Trillium Health Resources

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

⚕️ Healthcare Insurance

Healthcare Insurance • Mental Health • Substance Use

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

• Manage and coordinate claim issues received by providers, members, or other entities via telephone call, email, and ticket system. • Ensure timely responses to the provider community on the resolution of their issues. • Conduct claims research including review of claims processing system and previous/current tickets in the Claims Support Queue. • Draft provider-related communications and review trends of provider issues. • Make recommendations for updates needed in the Claims Processing System and Claims Staff training.

🎯 Requirements

• High School diploma/GED with a minimum of six (6) years of experience in coordinating multiple deadlines, drafting and reviewing written correspondence, and maintaining files and/or research in a healthcare or public health setting. • OR Associate’s degree with a minimum of four (4) years of experience in a healthcare or public health setting. • OR Bachelor’s degree with a minimum of two (2) years of experience in a healthcare or public health setting. • Minimum of six (6) years of extensive medical claims research including reviewing denials, member eligibility, communicating both written and verbally with the provider community, and analyzing claim reports. • Must have a valid driver’s license. • Must reside within North Carolina. • Must be able to travel within catchment as required.

🏖️ 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