Claims Processing Supervisor

Pay Plan Title: Supervisor

Working Title: Claims Processing Supervisor

Cost Center: 4300/Claims

Position Number: 81135

FLSA Status: Non-Exempt

Posting Salary Range: $44,367 - $58,434

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/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 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 is excited to announce a vacancy for the position of Claims Processing Supervisor! This pivotal role will be responsible for leading, maintaining, and enhancing the Medicaid and State funded claims processing services 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 in 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:

• Ensure claim reports are able to be generated by Claims Processing Assistants to work, will generate and distribute reports if needed.
• Ensure Claim Processing Assistants analyze, research and complete corrections denials, etc. as needed.
• Interact with provider network and between providers and Claims Processing Assistants addressing payment and claim processing issues.
• Maintain an understanding of the entire claims management system
• Answer phone calls and provide assistance to providers with claims questions
• Track and update Trillium’s ticket system to answer Provider questions.

Employee Benefits:

Trillium knows that work/life balance is essential. That’s why we offer:

• Typical working hours: 8:30 am – 5:00 pm
• 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 [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:

• High School diploma or GED and six (6) years of experience in a business-related field; or
• Associate’s degree and four (4) years of experience in a business-related field; or
• Equivalent combination of education/experience
• Must maintain a valid driver’s license
• Must reside in North Carolina.
• Must be able to travel within catchment as required.

Preferred:

• Experience in physical health claims processing is preferred.
• Experience with processing State funded and Medicaid claims is a plus.
• Deadline for Application: December 15,2025@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.

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