Manager, Claims

About the Role

Trillium Health Resources has a career opening for a Claims Manager to join our team. The Manager, Claims leads claims, analysis, and enrollment operations and is accountable for team performance, data integrity, and compliance. The role directs claims processing, reporting, and reimbursement activities and coordinates cross-functional efforts to support accurate claims payment and operational efficiency.

What You’ll Do

• Manage day-to-day operations of claims, analysis, and enrollment teams.
• Direct claims adjudication, reconciliation, auditing, and reporting activities.
• Analyze claims data to identify trends, risks, and opportunities for improvement.
• Oversee development and maintenance of reimbursement tables and procedures.
• Manage staff performance, development, and accountability.

Benefits

• Typical working hours: 8:30 am – 5:00 pm; flexible work schedules with some roles with management approval.
• 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).
• 401k with 5% employer match and immediate vesting.
• Public Service Loan Forgiveness (PSLF) qualifying employer.
• Quarterly stipend for remote work supplies.

Required Qualifications

• Associate's degree and three (3) years of experience with extensive claims filing and data reporting or eligibility and enrollment procedures; OR Bachelor's degree and one (1) year of experience with extensive claims filing and data reporting or eligibility and enrollment procedures; OR equivalent combination of education and experience.
• Must have a valid driver's license.
• Must reside within North Carolina.
• Must be able to travel within catchment as required.

Preferred Qualifications

• Advanced degree.
• Supervisory experience of two (2) or more employees.
• Physical Health claims experience.

Pay

$70,338 - $94,075