Eligibility & Enrollment Supervisor
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! Trillium Health Resources has a career opening for an Eligibility & Enrollment Supervisor to join our team! This position is responsible for providing assistance in developing and maintaining eligibility and enrollment procedures and ensuring these procedures are understood and followed by the Eligibility & Enrollment Specialists. This position is also responsible for performing data audits, data validation, software system testing, and supervisory duties.
Requirements
- High School diploma/GED and six (6) years of experience in eligibility determination for medical benefits, enrollment processing, claims processing and data reporting, or business-related field; OR Associate’s degree and four (4) years of experience in eligibility determination for medical benefits, enrollment processing, claims processing and data reporting, or business-related field; OR Equivalent combination of education/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 claims processing.
- Experience with processing State funded and Medicaid claims is a plus.
Responsibilities
- Process and approve enrollment requests for State Funds and member updates for Medicaid and State funded recipients 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 the State Funded benefit plan and eligibility criteria, different types of Medicaid and third-party insurance coverages held by members
- Generate working error and exception reports and make corrections to member data as necessary in Trillium’s software platform
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
Mid Level
Education Level
Associate degree
