Claims Processing Supervisor

Trillium Health Resources; North Carolina; Remote; USD 43,000 - 58,000; Full time

Job summary

An established industry player is looking for a Claims Processing Supervisor to join their dynamic team. This pivotal role focuses on overseeing and enhancing claims processing services, ensuring efficient resolution of provider issues related to claims submissions and payments. The ideal candidate will work closely with various departments, engage in claims adjudication, and train staff on essential duties. With a commitment to empowering others and fostering a diverse, inclusive culture, this organization offers a fulfilling work environment where employees can thrive both personally and professionally. If you are passionate about making a direct impact in the community, this opportunity is perfect for you.

Benefits

Health Insurance - no premium for employee coverage

Flexible Spending Accounts

Paid Time Off (PTO) of 24 days

12 paid holidays

401k with 5% employer match

Public Service Loan Forgiveness Qualifying Employer

Qualifications

• 4+ years of experience in a business-related field or equivalent education/experience.
• Experience in claims processing is preferred.

Responsibilities

• Oversee and enhance claims processing services supported by Medicaid.
• Resolve provider issues related to claims submissions and payments.

Skills

Claims Processing

Problem Solving

Team Collaboration

Training and Development

Education

Associate’s Degree

High School Diploma/GED

Job description

Trillium office based location as specified below: US

3 days ago Requisition ID: 2478

Salary Range:

FLSA Status: Non-Exempt

Posting Salary Range: $43,497 – $57,289

Office Location: Remote within 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

Trillium is excited to announce a vacancy for the position of Claims Processing Supervisor! This pivotal role will be responsible for overseeing, maintaining, and enhancing the claims processing services supported by Medicaid and the State for Trillium Health Resources. We seek a candidate who will work closely with the provider network, Claims Processing Assistants, and various departments within Trillium to effectively resolve provider issues related to claims submissions and payments. Key responsibilities include engaging with all aspects of claims adjudication, adjustments, and reporting, both administrative and technical. Furthermore, this position involves training staff on the essential duties linked to claims processing, making a strong grasp of the operational claims system and the overall workflow crucial for success in this role.

On a typical day, you might:

• Work closely with Claims Processing Assistants and other Trillium Departments to resolve provider issues in a timely manner relating to claims submissions and payments.
• Collaborate with all administrative, contractual, and technical aspects of claims adjudication, adjustments, and reporting.
• Be responsible for training staff on claims processing duties.

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:

• Typical working hours are 8:30am-5pm
• 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 the first year of employment
• 401k with 5% employer match & immediate vesting
• Public Service Loan Forgiveness Qualifying Employer

Qualifications:

Required Education/Experience:
An Associate’s Degree and a minimum of four (4) years’ experience in a business-related field.

OR

High School Diploma/GED and six (6) years’ experience in a business-related field.

OR

Equivalent combination of education/experience.

Preferred Experience:
Experience in claims processing is preferred.
Experience with processing State funded and Medicaid claims is a plus.

Required License/Certification:
Must have a valid driver’s license.

Location:
Remote within North Carolina. Must reside in North Carolina to be considered for remote status.

Deadline for application: Friday, January 31, 2025 at 11:59 p.m.

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
• Dates of service (month & year)
• Average number of hours worked per week
• Essential duties of the job as related to the position you’re applying for
• Education
• Degree type
• Date degree was awarded
• 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.

You will be notified by HR on the status of your application as appropriate. All applicants will receive a final email when the recruitment cycle for the position has closed.

Join our Talent Community through our ADP career center to stay informed about positions you may qualify for. Remember to keep an updated 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.