Key Facts

Remote From:

Indiana (USA) , North Carolina (USA)

Category: Conference Coordinator

Full time

Senior (5-10 years)

English

Hard Skills

Appeals Customer Complaint Resolution Provider Network Management Behavioral Health Working With The Developmentally Disabled Substance Dependence Mental Health And Recovery Services Human Services

Other Skills

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Communication
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Time Management
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Organizational Skills
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Detail Oriented

Roles & Responsibilities

High School Diploma/GED and six (6) years of experience in Behavioral/Mental Health, Developmental Disabilities, and Substance Abuse services
Associate’s degree and four (4) years of experience in Behavioral/Mental Health, Developmental Disabilities, and Substance Abuse services
Bachelor’s degree and two (2) years of experience in Behavioral/Mental Health, Developmental Disabilities, and Substance Abuse services
Must have a valid driver’s license and reside within North Carolina

Requirements:

Manage and coordinate complaints and grievance appeals, provider appeals, and claims appeals
Provide support and information to providers seeking to appeal an adverse Trillium action
Draft provider appeals resolution letters and monitor appeals policies based on legal requirements
Track appeal requests and ensure appeals files are maintained according to standards

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: Coordinator

Working Title: Provider Appeals Coordinator

FLSA Status: Exempt

Posting Salary Range: $54,106 - $67,210

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 Provider Appeals Coordinator to join our team! The Provider Appeals Coordinator is responsible for managing and coordinating complaints and grievance appeals, provider appeals, and claims appeals. This includes providing support and information to providers seeking to appeal an adverse Trillium action; scheduling provider panel hearings, when appropriate; drafting provider appeals resolution letters; monitoring and maintaining accurate appeals policies and procedures based on legal requirements; reporting and maintaining provider appeals statistics; and prepping provider appeals exhibits for Contested Case Hearings.

On a typical day, you might:

Ensure notification letters are updated and sent to the provider accurately and timely based on the most current formats and timelines as established by State and Federal regulations.
Track appeal requests and set up internal appeals panels, when needed.
Coordinate Trillium provider appeals requests.
Ensure all provider appeals files are maintained in accordance with 42CFR and contractual and accreditation standards.

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:

High School Diploma/GED and six (6) years of experience in Behavioral/Mental Health, Developmental Disabilities, and Substance Abuse services; OR
Associate’s degree and four (4) years of experience in Behavioral/Mental Health, Developmental Disabilities, and Substance Abuse services; OR
Bachelor’s degree and two (2) years of experience in Behavioral/Mental Health, Developmental Disabilities, and Substance Abuse services; 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:

A degree in a Human Services field.
Experience in the public mental health field is highly desired due to the complexity of the work of the organization.

Deadline for Application: Monday, June 1, 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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