[Hiring] Eligibility Enrollment Specialist I @TRILLIUM HEALTH RESOURCES

Role Description

Trillium Health Resources has a career opening for an Eligibility Enrollment Specialist I to join our team! The Eligibility Enrollment Specialists’ primary responsibilities include:

• Approving and processing enrollment requests and member updates.
• Verifying Medicaid eligibility and third-party insurance.
• Performing eligibility data integrity checks and corrections in Trillium’s software platform.

On a typical day, you might:

• Process and approve enrollment requests for State Funds and member updates for Medicaid and State funded members submitted by provider agencies.
• Monitor Medicaid eligibility and third-party insurance coverage of members and notify appropriate staff about changes and/or lapses in coverage that could affect service delivery.
• Verify members are appropriately enrolled as a Trillium member based on Medicaid eligibility data and State Funded eligibility criteria.
• Educate staff about types of Medicaid and third-party insurance coverages held by members.
• Verify pertinent member information in Trillium’s software platform and make corrections if necessary, based on policies and procedures.

Qualifications

• High School Diploma or GED and one (1) year of clerical experience; OR Equivalent combination of education/experience.
• Requires computer-related experience.
• Must have a valid driver’s license.
• Must reside within North Carolina.
• Must be able to travel within catchment as required.

• Experience in health care field and/or experience in Medicaid eligibility (preferred).

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.

Company Description

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.