Claims Processing Assistant
About The Position
Trillium Health Resources is a Tailored Plan and Managed Care Organization (MCO) serving 46 counties across North Carolina. We manage services for individuals with serious mental health needs, substance use disorders, traumatic brain injuries, and intellectual/development (IDD) disabilities. Our mission is to help individuals and families build strong foundations for healthy, fulfilling lives. Trillium Health Resources has a career opening for a Claims Processing Assistant to join our team! The Claims Processing Assistant is responsible for accurately inputting, generating, and tracking data within the MIS system. This role performs a variety of claims processing tasks, including assisting providers via phone or email with inquiries related to claims processing. Key responsibilities include managing multiple spreadsheets, ensuring data accuracy, resolving billing and payment discrepancies, and maintaining detailed records of provider communications. The position requires regular interaction with internal and external stakeholders to ensure timely and efficient claims resolution.
Requirements
- High school diploma or GED and one (1) year experience in claims processing, claims management, data entry and verification, insurance processing and documentation, adjudication and record maintenance, accounting, claims coding, medical documentation review, financial data analysis, or patient file analysis.
- Must have a valid driver’s license
- Must reside within North Carolina
- Must be able to travel within catchment as required.
Nice To Haves
- Experience with healthcare claims processing in a Managed Care environment.
- Certification in Healthcare Billing (CPB), CMRS, Certified Coding Professional (CCP) or equivalent certifications.
Responsibilities
- Provide training to the Provider community on the claims processing system.
- Accurately input claims and related data into the MIS system as needed.
- Analyze, research, and correct, if applicable, claims payments and denials.
- Generate and analyze claims payment and exception reports from the MIS system to identify issues; research, track, and resolve claim denials, discrepancies, etc.
- Provide technical assistance to providers via phone and email.
- Maintain filing system for all relevant paperwork.
Benefits
- Typical working hours: 8:30 am – 5:00 pm; flexible work schedules with some roles with management approval.
- Work-from-home options available for most positions
- 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
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
501-1,000 employees
