Claims Manager

Posted 3 Days Ago
Be an Early Applicant
Hiring Remotely in Location, WV, USA
In-Office or Remote
70K-94K Annually
Junior
Healthtech
The Role
Lead and oversee healthcare claims processing, ensure accurate payments and reporting, research and correct claim issues, manage appeals and provider inquiries, develop procedures, and train/mentor claims staff.
Summary Generated by Built In

Pay Plan Title: Unit Manager

Working Title: Claims Manager

FLSA Status: Exempt

Posting Salary Range: $70,338 - $94,075

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/developmental (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 Manager to join our team! In this key leadership role, the Claims Manager oversees the accurate and efficient processing of all healthcare claims, ensuring the integrity of claim data and delivering timely reporting and analysis. The Claims Manager manages claim-related inquiries, coordinates claim appeals, and work collaboratively across multiple internal teams to resolve provider issues.


On a typical day, you might:


  • 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:


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:

  • 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
  • Supervisory experience of two (2) or more employees
  • Physical Health claims experience 


Deadline for Application: August 13, 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

Skills Required

  • Associate's degree and three years claims filing and data reporting experience; OR Bachelor's degree and one year claims filing and data reporting experience; OR equivalent combination of education/experience
  • Extensive claims filing and data reporting experience
  • Valid driver's license
  • Must reside within North Carolina
  • Must be able to travel within catchment as required
  • Must pass a drug test as a condition of employment
  • Advanced degree
  • Supervisory experience of two or more employees
  • Physical health claims experience
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The Company
Greenville, North Carolina
646 Employees

What We Do

Trillium Health Resources manages specialty behavioral health care for North Carolinians across 46 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.

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