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Trillium Health Resources

Transforming Lives. Building Community Well-Being.

Claims Director

DirectorDirectorFull TimeRemoteLeadTeam 1,001-5,000H1B No SponsorCompany SiteLinkedIn

Location

North Carolina

Posted

2 days ago

Salary

$87.7K - $117.2K / year

Seniority

Lead

Bachelor Degree3 yrs expEnglish

Job Description

• Provide leadership, direction and management of the department • Responsible for gathering, researching and analyzing various data to aid Executive Management in decisions regarding provider services • Responsible for ensuring the identification of Medicaid and state funded covered services including retroactive Medicaid coverage to ensure appropriate enrollment and claims payment • Responsible for interaction between providers and department staff to address any enrollment, payment and billing issues • Responsible for maintaining an understanding of the entire claims management/AR system • Responsible for maintaining an understanding of Medicaid and State funded billing rules

Job Requirements

  • Bachelor’s degree in a business field
  • A minimum of three (3) years’ experience with extensive claims filing, data reporting, and financial analysis
  • Knowledge of Professional (Form CMS1500) Institutional (UB04) billing form, ICD-10/CPT/HCPCS coding/CAQH, HIPAA and claims processing
  • Must have a valid driver’s license
  • Must reside within North Carolina
  • Must be able to travel within catchment as required
  • Preferred: Master’s degree in related business field
  • Supervision of two (2) or more employees.

Benefits

  • 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)
  • 401k with 5% employer match and immediate vesting
  • Public Service Loan Forgiveness (PSLF) qualifying employer
  • Quarterly stipend for remote work supplies

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