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Appeals Support Specialist

extra holidays - fully flexible
Remote: 
Full Remote
Contract: 
Work from: 

Offer summary

Qualifications:

High School Diploma or GED required., Minimum of one year clerical experience or equivalent combination of education and experience., Preferred experience with Microsoft Office suite and four years of clerical and office management experience., Must have a valid driver's license. .

Key responsabilities:

  • Review and mail benefit determination letters for clinical and administrative denials.
  • Assist providers, members, and internal departments with technical assistance and general inquiries via phone or email.
  • Provide administrative support and resolve day-to-day issues as assigned.
  • Perform general clerical work, including scheduling events and recording meeting minutes.

Trillium Health Resources logo
Trillium Health Resources Insurance SME https://www.trilliumhealthresources.org/
501 - 1000 Employees
See all jobs

Job description

Pay Plan Title: Support Specialist

Working Title: Appeals Support Specialist

Position Number: 81037

FLSA Status: Non-Exempt

Posting Salary Range: $35,646 - $41,375

Office Location: Remote within North Carolina

POSTING DETAILS:

Make an Impact  

Trillium Health Resources is a local governmental agency (LME/MCO) in North Carolina that manages serious mental health, substance use, and intellectual/developmental disability services. Serving in 46 counties, we help individuals, and their families strengthen well-being and build foundations for a healthy life.

Join our team as we empower others to live their best lives by providing access to quality healthcare. We offer a challenging, engaging work environment where staff take home more than a paycheck. Every day, we see the results of our dedication – in the smiles of children on our accessible playgrounds and in the pride on the face of an adult cooking a meal for the first time. Working at Trillium Health Resources is more than just a job; it is an opportunity to make a direct impact on the communities we serve.

At Trillium, we know that empowering others begins with supporting and developing our team. That’s why we offer competitive benefits and work-from-home flexibility so that our employees thrive outside of the office. We’re also committed to building a diverse, inclusive culture where all employees have the potential to grow professionally and personally.

What We’re Looking For

Trillium Health Resources has an opening for a Support Specialist in our General Counsel & Appeals Team. We are seeking an individual who is detail-oriented, with the ability to prioritize and organize multiple tasks, effectively managing tasks from start to finish.

On a typical day, you might:

  • Review and mail benefit determination letters for clinical and administrative denials which may include peer-to-peer decision letters.
  • Assist providers, members, and internal departments with technical assistance and answer general questions received via phone call or email related to the benefit determination letters.
  • Provide administrative, clerical or custodial oversight or action to resolve day-to-day issues and assistance with projects or assignments as assigned.
  • Assist and provide back-up support to the Appeals Coordinators as needed.
  • Perform general clerical work, including scheduling and making arrangements for events, tracking departmental trainings and recording meeting minutes.

Employee Benefits:

Trillium knows that work/life balance is important. That’s why we offer our employees competitive benefits and flexibility that is second to none. Take a look at what we have to offer:

  • Typical working hours are 8:30am-5pm
  • A remote work option available for most positions
  • Health Insurance - no premium for employee coverage
  • Flexible Spending Accounts
  • Paid Time Off (PTO) of 24 days, plus 12 paid holidays within first year of employment
  • NC Local Government retirement pension. This is a defined-benefit retirement plan that will pay you a monthly amount upon retirement, for the rest of your life, with as little as five years of service. For more information, go to: https://files.nc.gov/retire/documents/files/Actives/LGERSHandbook.pdf
  • 401k with 5% employer match & immediate vesting
  • Public Service Loan Forgiveness Qualifying Employer

Qualifications: 

Education: 
 High School Diploma/GED.

Experience:
 
Minimum of one (1) year clerical experience.

OR

Equivalent combination of higher education/experience.

*Prefer experience with Microsoft Office suite and four (4) years clerical and office management experience preferred.

License/Certification:
 
Must have a valid driver’s license

Location:
 Remote within North Carolina.
Must reside in NC to be considered for remote status.

Deadline for application: Tuesday, March 25, 2025 at 11:59pm

To be considered for employment, all candidates are required to submit an application through ADP and upload a current resume.  Your resume must provide your level of education and detailed work experience, including: 

  • Employer Name
    1. Dates of service (month & year)
    2. Average number of hours worked per week
    3. Essential duties of the job as related to the position you’re applying for
  • Education
    1. Degree type
    2. Date degree was awarded
    3. Institution
  • Licensure/certification, if applicable

After submitting your application through our career center in ADP, your resume will be reviewed to ensure that your skills and experience meet the essential criteria for the role you have applied for.

You will be notified by HR on the status of your application as appropriate.  All applicants will receive a final email when the recruitment cycle for the position has closed.  

Join our Talent Community through our ADP career center to stay informed about positions you may qualify for. Remember to keep an update resume in the Talent Community profile. 

The diversity of the communities we serve is reflected in our employees. Trillium Health Resources is an Equal Employment Opportunity (EEO) employer.

Trillium Health Resources is a drug-free workplace. Candidates are required to pass a drug test as a condition of employment.

#Innovation  #Technology  #Careers  #NorthCarolina  #BehavioralHealth

Required profile

Experience

Industry :
Insurance
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Organizational Skills
  • Time Management
  • Detail Oriented
  • Communication

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