Job Details

Pay Plan Title: Claims Processing Assistant

Working Title: Claims Processing Assistant

FLSA Status: Non-Exempt

Posting Salary Range: $34,800 - $44,196

Office Location: Remote within North Carolina

POSTING DETAILS:

Make an Impact

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.

Why Work for Us?

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
• 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!

What We're Looking For

Trillium Health Resources has a career opening for a Claims Processing Assistant to join our team! The Claims Processing Assistant is responsible for accurately inputting, generating, and tracking data within the MIS system. This role performs a variety of claims processing tasks, including assisting providers via phone or email with inquiries related to claims processing. Key responsibilities include managing multiple spreadsheets, ensuring data accuracy, resolving billing and payment discrepancies, and maintaining detailed records of provider communications. The position requires regular interaction with internal and external stakeholders to ensure timely and efficient claims resolution.

On a typical day, you might:

• Provide training to the Provider community on the claims processing system.
• Accurately input claims and related data into the MIS system as needed.
• Analyze, research, and correct, if applicable, claims payments and denials.
• Generate and analyze claims payment and exception reports from the MIS system to identify issues; research, track, and resolve claim denials, discrepancies, etc.
• Provide technical assistance to providers via phone and email.
• Maintain filing system for all relevant paperwork.

Employee Benefits:

Trillium knows that work/life balance is essential. That's why we offer:

• Typical working hours: 8:30 am - 5:00 pm; flexible work schedules with some roles with management approval.
• Work-from-home options available 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

Qualifications

Required:

• High school diploma or GED and one (1) year experience in claims processing, claims management, data entry and verification, insurance processing and documentation, adjudication and record maintenance, accounting, claims coding, medical documentation review, financial data analysis, or patient file analysis.
• Must have a valid driver's license
• Must reside within North Carolina
• Must be able to travel within catchment as required.

Preferred:

• Experience with healthcare claims processing in a Managed Care environment.
• Certification in Healthcare Billing (CPB), CMRS, Certified Coding Professional (CCP) or equivalent certifications.

Deadline for Application: Open until filled

How to Apply

To be considered, submit your application and resume through our ADP Career Center. Your resume must include:

• Employer name, dates of service (month/year), average hours worked per week, and essential job duties
• Education details (degree type, date awarded, institution, field of study)
• Licensure/certification information, if applicable

After submission, your resume will be reviewed to ensure it meets the essential criteria for the position. You'll be notified by HR regarding your application status as appropriate. All applicants will receive a final update once the recruitment cycle closes.

Join our Talent Community through ADP to stay informed about future opportunities. Be sure to keep your resume updated in your profile.

Trillium Health Resources is an Equal Employment Opportunity (EEO) employer and a drug-free workplace. All candidates must pass a drug test as a condition of employment.

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