Claims Manager

Claims Manager

Location: Remote within North Carolina. FLSA Status: Exempt. Cost Center: 4300/Claims. Position Number: 80744.

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.

Base Pay Range

$67,632.00/yr - $90,457.00/yr

Key Responsibilities

• 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

• 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 the first year.
• 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.

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.

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.