Claims Relations Coordinator

About the role

The Claims Relations Coordinator is responsible for managing and coordinating claim issues received by providers, members, or other entities via telephone call, email, and ticket system. This position involves providing support and information to the provider community, researching and gathering necessary information regarding claim issues, and relaying the resolution and/or summary of these issues to the provider community.

Responsibilities

• Manage and coordinate calls and tickets related to claim issues.
• Update and respond to claims ticket queue and call logs in a timely manner to ensure timely notifications to the provider community.
• Conduct claims research, including reviewing claims processing system, previous and current tickets, paper claim logs, and collaborating with other claims staff.
• Avoid provider technical assistance and assist with drafting provider-related communications.
• Review trends of provider issues and make recommendations for updates needed in the Claims Processing System and Claims Staff training.

Requirements

Requirements include a bachelor’s degree in healthcare administration, business administration, or a related field, or equivalent combination of education and experience. Experience in healthcare claims processing, customer service, and problem-solving is preferred.

Qualifications

Must have excellent communication skills, both verbal and written. Proficiency in Microsoft Office Suite is required. Familiarity with healthcare claims systems and processes is beneficial.

Skills

• Excellent communication skills (verbal and written).
• Proficiency in Microsoft Office Suite.
• Familiarity with healthcare claims systems and processes.

Benefits

Trillium Health Resources offers typical working hours of 8:30 am - 5:00 pm, flexible work schedules, and work-from-home options for most positions. Additional benefits include:

• 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).

Pay

$54,106 - $67,210 annually.

Schedule

Typical working hours: 8:30 am - 5:00 pm; flexible work schedules with some roles with management approval.