Remote Claims Specialist III — Healthcare Support

Trillium Health Resources; North Carolina; Hybrid; USD 56,000 - 70,000; Full time

Benefits offered by this job

Health Insurance with no employee-prem

401k with employer match

PSLF qualifying employer

Paid time off + holidays

Job summary

Trillium Health Resources is seeking a Claims Specialist III for remote work within North Carolina. The role manages and coordinates claim issues via calls, emails, and tickets, researching and communicating resolutions to providers and state entities.

Ideal candidates have a healthcare/public health claims background, strong research skills, and the ability to work remotely with occasional travel within the catchment. Excellent benefits are provided.

Qualifications

• High school diploma or GED with 6 years in healthcare/public health claims research
• Associate's degree with 4 years in healthcare/public health claims research
• Bachelor's degree with 2 years in healthcare/public health claims research
• Equivalent combination of education and experience
• Must have a valid driver’s license
• Must reside within North Carolina
• Must be able to travel within catchment as required
• Must be legally authorized to work in the United States without sponsorship

Responsibilities

• Coordinate and manage calls and tickets.
• Ensure claims ticket queue and call logs are updated and responded to timely.
• Conduct claims research including review of claims processing system and related tickets.
• Assist with drafting provider communications.
• Review trends of provider issues and recommend updates to Claims Processing System and staff training.

Education

High school diploma or GED

Associate's degree

Bachelor's degree

Equivalent combination of education and experience

Job description

Trillium Health Resources is seeking a Claims Specialist III for remote work within North Carolina. The role manages and coordinates claim issues via calls, emails, and tickets, researching and communicating resolutions to providers and state entities.

Ideal candidates have a healthcare/public health claims background, strong research skills, and the ability to work remotely with occasional travel within the catchment. Excellent benefits are provided.