Eligibility Enrollment Specialist I
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 believes that empowering others begins with supporting our team. We offer our employees a collaborative, mission-driven work environment, competitive benefits and work-from-home options for most positions, and opportunities for professional growth in a diverse inclusive culture. Every day, our work changes lives – from children thriving through early intervention and school-based therapies, to adults with severe mental illness living independently and contributing to their communities. If you are looking for a unique opportunity to make a tangible impact on the lives of others, apply today!
Requirements
- High School Diploma or GED required.
- One (1) year of clerical experience required, 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
- Approving and processing enrollment requests and member updates
- Verifying Medicaid eligibility
- Verifying third party insurance
- Performing eligibility data integrity checks and corrections in Trillium’s software platform
- 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
