[Hiring] Eligibility & Enrollment Supervisor @TRILLIUM HEALTH RESOURCES

Role Description

Trillium Health Resources has a career opening for an Eligibility & Enrollment Supervisor to join our team! This position is responsible for providing assistance in developing and maintaining eligibility and enrollment procedures and ensuring these procedures are understood and followed by the Eligibility & Enrollment Specialists. This position is also responsible for performing data audits, data validation, software system testing, and supervisory duties.

On a typical day, you might:

• Process and approve enrollment requests for State Funds and member updates for Medicaid and State funded recipients 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 the State Funded benefit plan and eligibility criteria, different types of Medicaid and third-party insurance coverages held by members.
• Generate working error and exception reports and make corrections to member data as necessary in Trillium’s software platform.

Qualifications

• High School diploma/GED and six (6) years of experience in eligibility determination for medical benefits, enrollment processing, claims processing and data reporting, or business-related field; OR
• Associate’s degree and four (4) years of experience in eligibility determination for medical benefits, enrollment processing, claims processing and data reporting, or business-related field; OR
• Equivalent combination of education/experience.
• Must have a valid driver’s license.
• Must reside within North Carolina.
• Must be able to travel within catchment as required.

Requirements

• Experience in claims processing.
• Experience with processing State funded and Medicaid claims is a plus.

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.