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Claims Relations Coordinator

Role overview

Qualifications

  • High School diploma/GED with a minimum of six (6) years of experience in healthcare or public health
  • Associate’s degree with a minimum of four (4) years of experience in healthcare or public health
  • Bachelor’s degree with a minimum of two (2) years of experience in healthcare or public health
  • Must have a valid driver’s license and reside within North Carolina

Responsibilities

  • Manage and coordinate claim issues received by providers, members, or other entities
  • Conduct claims research and review trends of provider issues
  • Assist with drafting provider-related communications
  • Track, review, and coordinate responses to inquiries and claims issues

Key facts

Other skills

  • Research
  • Problem Solving
  • Interpersonal Communications

About the company

Trillium Health Resources logo

Trillium Health Resources

Health Insurance (Payers)

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 details

Company typeSME
IndustryHealth Insurance (Payers)
Company size501 - 1000

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Job description

Pay Plan Title: Coordinator

Working Title: Claims Relations 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 Claims Relations Coordinator to join our Claims team! The Claims Relations Coordinator is responsible for managing and coordinating claim issues received by providers, members, or other entities via telephone call, email, and ticket system. The coordination of claim issues includes providing support and information to the provider community. This position will research and gather necessary information regarding claim issues and relay the resolution and/or summary of these issues to the provider community. The Claims Relations Coordinator will also be responsible for tracking, reviewing, and coordinating timely and accurate responses that may include inquiries, claims issues, and escalations submitted by the State Department.


On a typical day, you might:


  • 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.


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 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.


Deadline for Application: Monday July 27, 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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