Provider Relations & Engagement Specialist

TRILLIUM HEALTH RESOURCES

1d•Remote

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 a Provider Relations and Engagement Specialist to join our team! The Provider Relations and Engagement Specialist functions as the connection between providers and Trillium. They perform a variety of tasks depending on the needs of the provider, including answering questions about insurance claims, processing grievances and/or complaints, and assisting with the onboarding of providers. The Provider Relations and Engagement Unit may often be the first interaction with the organization; therefore, the Provider Relations and Engagement Specialist must respond to the provider’s needs in a way to build a positive, professional partnership. Operating in a service-oriented manner and maintaining the highest level of customer satisfaction requires ensuring that the questions, concerns, or issues are resolved while tracking outcomes.

Requirements

High School Diploma/GED and minimum of one (1) year clerical experience; OR Equivalent combination of higher education/experience.
Must have a valid driver’s license.
Must reside within Trillium’s Catchment of North Carolina. Counties included: Anson, Bertie, Beaufort, Bladen, Brunswick, Camden, Chowan, Carteret, Columbus, Craven, Currituck, Dare, Duplin, Edgecombe, Gates, Greene, Guilford, Halifax, Hertford, Hoke, Hyde, Jones, Lee, Lenoir, Martin, Montgomery, Moore, Nash, New Hanover, Northampton, Onslow, Pamlico, Pasquotank, Pender, Perquimans, Pitt, Randolph, Richmond, Robeson, Sampson, Scotland, Tyrrell, Warren, Washington, Wayne, Wilson.
Must be able to travel within catchment as required.

Nice To Haves

Two (2) years’ clerical/direct customer service with six months in a call center or an insurance setting.
Twelve (12) months experience in mental health, substance abuse and developmental disabilities field.

Responsibilities

Prepare, process, and review oral and written material.
Assist in preparation of informational documents, reports and/or special projects as requested by Network Management.
Develop and maintain effective channels of communication with service providers through telephone calls, prompt resolution of issues, and excellent customer service.
Respond to provider inquiries within the designated call response time of one business day.
Gather and/or update data, such as but not limited to demographic information, provider name, and nature of question or complaint.