Key Facts

Remote From:

Full time

Mid-level (2-5 years)

English

Hard Skills

Payment Service Provider Claims And Litigation Management Cross-Functional Collaboration Billing Inquiries Compliance Management Claims And Litigation Management Higher Education Client Services

Other Skills

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Communication
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Analytical Skills
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Time Management
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Analytical Thinking
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Detail Oriented
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Problem Solving

Roles & Responsibilities

Associate’s degree with three years of extensive claims filing and data reporting, or a Bachelor’s degree with at least one year of such experience, or an equivalent combination of education and experience.
Must have a valid driver's license.
Must reside within North Carolina and be able to travel within the catchment as required.
Preferred: Advanced degree; Supervisory experience of two or more employees; Physical Health claims experience.

Requirements:

Ensure claims payment reports are generated and analyzed to determine problems.
Ensure analysis, research, and corrections are completed in a timely manner to ensure provider payment.
Assist in developing and maintaining claim processing procedures and ensuring these procedures are understood and followed by claims staff.
Train and mentor staff on claims processing duties to enhance team performance.

Trillium Health Resources

Insurance

About Trillium Health Resources

Trillium Health Resources manages specialty behavioral health care for eastern North Carolinians across 28 counties. Trillium is committed to transforming lives and building community well-being through partnership, access to services and proven solutions designed to help those we serve reach their fullest potential. Everyone on Trillium’s staff--our care managers, call center, claims agents, project managers, and IT staff--all contribute to this mission. We offer a challenging, engaging work environment where staff take home more than a paycheck. Our performance management plan includes regular check-ins to examine individual employee goals and professional development plan. Our departments work on cross-functional, short-term projects and long ranging initiatives. Every day we see the results of our dedication, in the smiles of children on our accessible playgrounds and pride on the face of an adult cooking a meal for the first time. By joining Trillium, you are doing more than going to work…you are transforming lives. We help those with mental health conditions, intellectual and developmental disabilities, traumatic brain injury, and substance use disorders (Medicaid members and state-funded recipients) get the services they need to improve well-being and live fulfilling lives. We are dedicated to carrying out our mission by investing in the health and well-being of the communities we serve and empowering individuals with access to services, tools and resources to live a fulfilling life. Trillium reserves the right to hide material (comments, images and/or links to other sites) that contains anything vulgar or sexually explicit; is spam; advocates or depicts illegal activity; targets or disparages any ethnic, racial, other type of group; contains personal attacks of any kind; promotes private business ventures, services, or products; campaigns for public office or promotes a political organization; infringes on copyrights or trademarks; or is off topic.

Company type: SME

Industry: Insurance

Founded: 2018

Company size: 501 - 1000

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Job description

Pay Plan Title: Unit Manager

Working Title: Claims Manager

FLSA Status: Exempt

Posting Salary Range: $67,632 - $90,457

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/developmental (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 Manager to join our team! The Claims Manager is responsible for ensuring accurate processing of all claims, the appropriate data elements required to process claims accurately, and reporting and analysis of claims data, including responding to claim appeals. This position will work closely with the Claims Processing Supervisors and Claims Processing Assistants to resolve provider-related issues related to claims submissions and payments in a timely manner. This position will also work closely with the Fiscal Analyst Manager to resolve claim issues and with Trillium’s Appeals Team on claim appeals.

On a typical day, you might:

Ensure claims payment reports are generated and analyzed to determine problems.
Ensure analysis, research, and corrections are completed in a timely manner to ensure provider payment.
Assist in developing and maintaining claim processing procedures and ensuring these procedures are understood and followed by claims staff.
Interact with the provider community to address billing issues.
Train and mentor staff on claims processing duties to enhance team performance.

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) https://www.myncretirement.gov/systems-funds/local-governmental-employees-retirement-system-lgers/lgers-handbook
401k with 5% employer match and immediate vesting
Public Service Loan Forgiveness (PSLF) qualifying employer
Quarterly stipend for remote work supplies

Qualifications

Required:

Associate’s degree and three (3) years of experience with extensive claims filing and data reporting; OR
Bachelor’s degree and a minimum of one (1) year of experience with extensive claims filing and data reporting; 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:

Advanced degree preferred.
Supervisory experience of two (2) or more employees
Physical Health claims experience

Deadline for Application: May 12, 2026 at 11:59pm

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.

#Innovation #Technology #Careers #NorthCarolina #BehavioralHealth

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