Trillium Health Resources · 12 hours ago
Claims Relations Coordinator
United States
Full-time
Remote
Entry, Mid Level
$54K/yr - $67K/yr
2+ years expTrillium Health Resources is a Tailored Plan and Managed Care Organization serving 46 counties across North Carolina. They are seeking a Claims Relations Coordinator to manage and coordinate claim issues received from providers and members, ensuring timely communication and resolution.
Child CareHealth CareMental HealthNon Profit
Responsibilities
Coordinate and manage calls and tickets
Ensure claims ticket queue and call logs are updated and responded to timely to allow for timely notifications to the provider community on the resolution and/or summary of their issues
Conduct claims research, including, but not limited to, review of claims processing system, review of previous and current tickets in the Claims Support Queue, review of paper claim logs, working with other claims staff to learn history, third party biller impacts, Remittance Advice notifications and provider technical assistance
Assist with drafting provider related communications
Review trends of provider issues and make recommendations for updates needed in the Claims Processing System and Claims Staff training
Qualification
Required
High School diploma/GED with a minimum of six (6) years of experience in coordinating multiple deadlines, drafting and reviewing written correspondence, and maintaining files and/or research in a healthcare or public health setting which includes a minimum of six (6) years of extensive medical claims research including reviewing denials, member eligibility, communicating both written and verbally with the provider community, and analyzing claim reports; OR
Associate's degree with a minimum of four (4) years of experience in coordinating multiple deadlines, drafting and reviewing written correspondence, and maintaining files and/or research in a healthcare or public health setting which includes a minimum of four (4) years of extensive medical claims research including reviewing denials, member eligibility, communicating both written and verbally with the provider community, and analyzing claim reports; OR
Bachelor's degree with a minimum of two (2) years of experience in coordinating multiple deadlines, drafting and reviewing written correspondence, and maintaining files and/or research in a healthcare or public health setting which includes a minimum of two (2) years of extensive medical claims research including reviewing denials, member eligibility, communicating both written and verbally with the provider community, and analyzing claim reports; 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
Preferred
Degree in Business Administration, Healthcare Administration, Human Services, Public Administration, Liberal Arts, or Humanities
Experience in the public mental health field is highly desired due to the complexity of the work of organization
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
Company
Trillium Health Resources
Trillium Health Resources is a local governmental agency for individuals with serious mental health, and intellectual disability services.
Founded in 1972Greenville, North Carolina, USA
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Joy Futrell
Chief Executive Officer
Cindy Ehlers MS LCMHC
Chief Operating Officer
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