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Trillium Health Resources is a local governmental agency (LME/MCO) in North Carolina that manages serious mental health, substance use, and intellectual/developmental disability services. Serving in 28 counties, we help individuals and their families strengthen well-being and build foundations for a healthy life.

Join our team as we empower others to live their best lives by providing access to quality healthcare. We offer a challenging, engaging work environment where staff take home more than a paycheck. Every day, we see the results of our dedication – in the smiles of children on our accessible playgrounds and in the pride on the face of an adult cooking a meal for the first time. Working at Trillium Health Resources is more than just a job; it is an opportunity to make a direct impact on the communities we serve.

At Trillium, we know that empowering others begins with supporting and developing our team. That’s why we offer competitive benefits and work-from-home flexibility so that our employees thrive outside of the office. We’re also committed to building a diverse, inclusive culture where all employees have the potential to grow professionally and personally.

What We’re Looking For

Trillium Health Resources is seeking a Claims Appeals Coordinator to join our Claims team. This position is responsible for managing and coordinating claim appeals for the Claims Department and in coordination with other Trillium teams and staff. The coordination of claim appeals includes: providing support and information to the Appeals Team, researching and pulling needed information regarding claim appeals and submitting it to the Appeals Team, and assisting with logging of claim appeals. The Claims Appeals Coordinator is a vital member of the Claims team, working to ensure adequate record documentation and data for accreditation standards, auditing, and funding requirements.

On a typical day, you might:

• Ensure the claims appeal log is updated timely to allow for timely notifications to the Appeals Team.
• Conduct claims appeal research including, but not limited to:
  • review of the claims processing system & paper claim logs,
  • working with other claims staff to learn claim history,
  • review of third party biller impacts & Remittance Advice notifications,
  • and assisting with provider technical assistance.
• Update and complete the Claims Appeal Tracking log when the Claims Support Specialist assigned that duty is out of the office.

Employee Benefits:

Trillium knows that work/life balance is important. That’s why we offer our employees competitive benefits and flexibility that is second to none. Take a look at what we have to offer:

• Flexible Work Schedules
• Health Insurance - no premium for employee coverage
• Flexible Spending Accounts
• Paid Time Off (PTO) of 23 days, plus 10 paid holidays within first year of employment
• NC Local Government retirement pension, plus 401k with 5% employer match & immediate vesting
• Public Service Loan Forgiveness Qualifying Employer

Qualifications:

Education: Bachelor’s Degree

Preferred in Business Administration, Healthcare Administration, Human Services, Public Administration, Liberal Arts, or Humanities.

Experience: Minimum of two (2) years’ experience in coordinating multiple deadlines, drafting and reviewing written correspondence, and maintaining files and/or research in a healthcare or public health setting which includes a minimum of two (2) years of extensive medical claims research including reviewing denials, member eligibility, and analyzing claim reports.; or equivalent of higher education or higher education/experience.

Preferred experience in the public mental health field is highly desired due to the complexity of the work of the organization.

License/Certification: n/a

Must have a valid driver’s license

Must reside in NC to be considered for remote status

Deadline for application: April 13, 2023 at 11:59pm

To be considered for employment, all candidates are required to submit an application through ADP and upload a current resume. Your resume must provide your level of education and detailed work experience, including:

• Employer Name
  • Dates of service (month & year)
  • Average number of hours worked per week
  • Essential duties of the job as related to the position you’re applying for
• Education
  • Degree type
  • Date degree was awarded
  • Institution
• Licensure/certification, if applicable

After submitting your application through our career center in ADP, your resume will be reviewed to ensure that your skills and experience meet the essential criteria for the role you have applied for.

The diversity of the communities we serve is reflected in our employees. Trillium Health Resources is an Equal Employment Opportunity (EEO) employer.

Trillium Health Resources is a drug-free workplace. Candidates are required to pass a drug test as a condition of employment.

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