Manager, Claims
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/developmental (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 a Claims Manager to join our team! The Manager, Claims leads claims, analysis, and enrollment operations and is accountable for team performance, data integrity, and compliance. The role directs claims processing, reporting, and reimbursement activities and coordinates cross-functional efforts to support accurate claims payment and operational efficiency.
Requirements
- Associate's degree and three (3) years of experience with extensive claims filing and data reporting or eligibility and enrollment procedures; OR Bachelor's degree and one (1) year of experience with extensive claims filing and data reporting or eligibility and enrollment procedures; OR Equivalent combination of education and 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
- Advanced degree
- Supervisory experience of two (2) or more employees
- Physical Health claims experience
Responsibilities
- Manage day-to-day operations of claims, analysis, and enrollment teams.
- Direct claims adjudication, reconciliation, auditing, and reporting activities.
- Analyze claims data to identify trends, risks, and opportunities for improvement.
- Oversee development and maintenance of reimbursement tables and procedures.
- Manage staff performance, development, and accountability.
Benefits
- Competitive benefits
- Work-from-home options 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
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
Associate degree
