Claims Analysis Manager

Pay Plan Title: Unit Manager

Working Title: Claims Analysis Manager

Cost Center: 43/Claims

Position Number: 54055

FLSA Status: Exempt

Posting Salary Range: $66,306 - $76,915

Office Location: Remote in North Carolina 

POSTING DETAILS:

Make an Impact  

Trillium Health Resources is a local governmental agency (LME/MCO) in North Carolina that manages serious mental health, substance use, and intellectual/developmental disability services. Serving in 46 counties, we help individuals, and their families strengthen well-being and build foundations for a healthy life.

Join our team as we empower others to live their best lives by providing access to quality healthcare. We offer a challenging, engaging work environment where staff take home more than a paycheck. Every day, we see the results of our dedication – in the smiles of children on our accessible playgrounds and in the pride on the face of an adult cooking a meal for the first time. Working at Trillium Health Resources is more than just a job; it is an opportunity to make a direct impact on the communities we serve.

At Trillium, we know that empowering others begins with supporting and developing our team. That’s why we offer competitive benefits and work-from-home flexibility so that our employees thrive outside of the office. We’re also committed to building a diverse, inclusive culture where all employees have the potential to grow professionally and personally.

What We’re Looking For:

We are looking for a Claims Analysis and Auditing Manager to join our team and drive the continued success of the claims department. You will take charge of maintaining and enhancing the claims functions. You will   be involved in analyzing claims data, identifying trends, and ensuring systems integrity, and recommending improvement to enhance operational efficiency. 

On a typical day, you might:

• Analyze data and trends and utilize quality management tools. 
• Develop initiatives to improve efficiency and effectiveness. 
• Develop and analyze claims data audit reports. 
• Examine trends, claim statistics, and provider payments to monitor achievement of department goals, improve processes, and determine claims processing accuracy/timeliness.

Employee Benefits:

Trillium knows that work/life balance is important. That’s why we offer our employees competitive benefits and flexibility that is second to none. Take a look at what we have to offer:

• A remote work option available for most positions
• Health Insurance - no premium for employee coverage
• Flexible Spending Accounts
• Paid Time Off (PTO) of 24 days, plus 12 paid holidays within first year of employment
• NC Local Government retirement pension. This is a defined-benefit retirement plan that will pay you a monthly amount upon retirement, for the rest of your life, with as little as five years of service. For more information, go to: https://files.nc.gov/retire/documents/files/Actives/LGERSHandbook.pdf
• 401k with 5% employer match & immediate vesting
• Public Service Loan Forgiveness Qualifying Employer

Qualifications: 

Education: High School/GED, Associate’s, Bachelor’s

Preferred Education: Prefer degree in Accounting or Business Administration/ Business Management.

Experience: 

• Bachelor’s degree and a minimum of one (1) year experience with extensive claims filing and data reporting, OR
•  Associate’s degree and three (3) years’ experience with extensive claims filing and data reporting, 
• OR High School diploma/GED and five (5) years’ experience with extensive claims filing and data reporting, 
• OR Equivalent combination of education/experience

Preferred Experience: Supervision of 2 or more employees.

License/Certification: n/a

Must have a valid driver’s license

Must reside in North Carolina to be considered for remote status 

Deadline for application:   October 21, 2024 at 11:59PM

To be considered for employment, all candidates are required to submit an application through ADP and upload a current resume.  Your resume must provide your level of education and detailed work experience, including: 

• Employer Name
  1. Dates of service (month & year)
  2. Average number of hours worked per week
  3. Essential duties of the job as related to the position you’re applying for
• Education
  1. Degree type
  2. Date degree was awarded
  3. Institution
• Licensure/certification, if applicable

After submitting your application through our career center in ADP, your resume will be reviewed to ensure that your skills and experience meet the essential criteria for the role you have applied for.

Join our Talent Community through our ADP career center to stay informed about positions you may qualify for. Remember to keep an update resume in the Talent Community profile. 

The diversity of the communities we serve is reflected in our employees. Trillium Health Resources is an Equal Employment Opportunity (EEO) employer.

Trillium Health Resources is a drug-free workplace. Candidates are required to pass a drug test as a condition of employment.

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