Provider Relations Specialist I
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Job Description
Provider relations specialist connecting North Carolina healthcare providers with Trillium Health Resources, a behavioral-health managed care organization. Handling claims inquiries, grievances, onboarding, provider communication, and data updates remotely.
Responsibilities:
- Serve as the connection between providers and Trillium
- Answer questions about insurance claims
- Process grievances and/or complaints
- Assist with onboarding providers
- Respond to provider needs to build positive, professional partnerships
- Resolve questions, concerns, and issues while tracking outcomes
- Prepare, process, and review oral and written material
- Assist with informational documents, reports, and special projects requested by Network Management
- Develop and maintain communication channels with service providers through telephone calls
- Respond to provider inquiries within one business day
- Gather and/or update demographic information, provider names, and the nature of questions or complaints
Requirements:
- High School Diploma/GED and minimum of one (1) year clerical experience; OR equivalent combination of education/experience
- Valid driver's license
- Must reside within Trillium's Catchment of North Carolina
- Must be able to travel within catchment as required
- Preferred: Two (2) years' clerical/direct customer service with six months in a call center or an insurance setting
- Preferred: Twelve (12) months experience in mental health, substance abuse and developmental disabilities field
- All candidates must pass a drug test as a condition of employment
Benefits:
- A collaborative, mission-driven work environment
- Competitive benefits and work-from-home options for most positions
- Opportunities for professional growth in a diverse inclusive culture
- 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
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