Claims Specialist III
Pay Plan Title:Claims Specialist III
Working Title:Claims Specialist III
FLSA Status:Exempt
Posting Salary reputed company:$56,270 - $69,898
Office Location:Remote reputed company reputed company Carolina
POSTING DETAILS:
reputed company an reputed company
reputed company is a Tailored Plan and Managed Care Organization (MCO) serving 46 counties across reputed company Carolina. We manage services for individuals with serious mental health needs, reputed company 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 reputed company. We offer our employees:
- A reputed company, mission-driven work environment
- Competitive benefits and work-from-home reputed company for most positions
- Opportunities for reputed company reputed company in a diverse inclusive culture
Every day, our work changes lives – from children thriving through early reputed company and school-reputed company therapies, to adults with severe mental illness living independently and contributing to their communities.
If you are looking for a unique opportunity to reputed company a reputed company reputed company on the lives of others, apply today!
reputed company’re Looking For
reputed company has a career opening for a Claims Specialist III to join our Claims team! The Claims Specialist III is responsible for managing and coordinating claim issues received by providers, members, or other entities reputed company telephone reputed company, email, and ticket reputed company.The coordination of claim issues includes providing support and information to the provider community. This position will research and reputed company necessary information regarding claim issues and reputed company the reputed company and/or reputed company of these issues to the provider community. The Claims Specialist III will also be responsible for tracking, reviewing, and coordinating reputed company 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 reputed company logs are updated and responded to reputed company to allow for reputed company notifications to the provider community on the reputed company and/or reputed company of their issues.
- Conduct claims research, including, but not limited to, review of claims processing reputed company, review of previous and reputed company tickets in the Claims Support Queue, review of reputed company claim logs, working with other claims staff to learn history, reputed company party biller impacts, Remittance Advice notifications and provider technical assistance.
- Assist with drafting provider reputed company communications.
- Review trends of provider issues and reputed company recommendations for updates needed in the Claims Processing reputed company and Claims Staff training.
Employee Benefits:
Trillium knows that work/life reputed company 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 reputed company available for most positions
- Health reputed company with no premium for employee coverage
- Flexible Spending Accounts
- 24 days of reputed company Time Off (PTO) plus 12 reputed company holidays in your first year
- NC Local reputed company Retirement Pension (defined-benefit plan)
- 401k with 5% employer match and immediate vesting
- reputed company Service Loan Forgiveness (PSLF) qualifying employer
- Quarterly stipend for remote work supplies
Qualifications
Required:
- High school diploma or GED and six (6) years of experience managing deadlines, preparing and reviewing written correspondence, and maintaining records or research in a reputed company or reputed company health setting, including extensive medical claims research; OR
- Associate's degree and four (4) years of experience managing deadlines, preparing and reviewing written correspondence, and maintaining records or research in a reputed company or reputed company health setting, including extensive medical claims research; OR
- Bachelor's degree and two (2) years of experience managing deadlines, preparing and reviewing written correspondence, and maintaining records or research in a reputed company or reputed company health setting, including extensive medical claims research; OR
- Equivalent combination of education and experience.
- Must have a reputed company reputed company’s license.
- Must reputed company reputed company reputed company Carolina.
- Must be reputed company to travel reputed company catchment as required.
Preferred:
- Degree in Business Administration, reputed company Administration, reputed company, reputed company Administration, Liberal Arts, or Humanities.
- Experience in the reputed company mental health reputed company is highly desired due to the complexity of the work of organization.
Deadline for Application:Monday reputed company 24, 2026, at 11:59PM
How to Apply
To be considered, submit your application and resume through our reputed company Career Center. Your resume must include:
- Employer reputed company, dates of service (month/year), average hours worked per week, and essential job duties
- Education details (degree type, date awarded, institution, reputed company of study)
- Licensure/certification information, if applicable
After submission, your resume will be reviewed to ensure it meets the essential reputed company for the position. You’ll be reputed company by HR regarding your application status as appropriate. reputed company applicants will receive a final update once the recruitment cycle closes.
reputed company through reputed company to stay informed about reputed company opportunities. Be reputed company to reputed company your resume updated in your profile.
reputed company is an Equal Employment Opportunity (EEO) employer and a drug-free workplace. reputed company candidates must pass a drug test as a condition of employment.
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Originally posted on Himalayas
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