Eligibility Enrollment Specialist I
About The Position
Trillium Health Resources is seeking an Eligibility Enrollment Specialist I to join their team. This role is responsible for approving and processing enrollment requests and member updates, verifying Medicaid eligibility, verifying third-party insurance, and performing eligibility data integrity checks and corrections within Trillium’s software platform. Trillium Health Resources is a Tailored Plan and Managed Care Organization serving 46 counties in North Carolina, managing services for individuals with serious mental health needs, substance use disorders, traumatic brain injuries, and intellectual/developmental disabilities. The organization's mission is to help individuals and families build strong foundations for healthy, fulfilling lives. They offer a collaborative, mission-driven work environment, competitive benefits, work-from-home options, and opportunities for professional growth.
Requirements
- High School Diploma or GED and one (1) year of clerical experience; OR Equivalent combination of education/experience.
- Requires computer-related experience.
- 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 in health care field and/or experience in Medicaid eligibility.
Responsibilities
- Process and approve enrollment requests for State Funds and member updates for Medicaid and State funded members submitted by provider agencies.
- Monitor Medicaid eligibility and third-party insurance coverage of members and notify appropriate staff about changes and/or lapses in coverage that could affect service delivery.
- Verify members are appropriately enrolled as a Trillium member based on Medicaid eligibility data and State Funded eligibility criteria.
- Educate staff about types of Medicaid and third-party insurance coverages held by members.
- Verify pertinent member information in Trillium’s software platform and make corrections if necessary, based on policies and procedures.
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
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
