Appeals Support Specialist

Role Overview

• Provide confidential administrative and specialist support to General Counsel/Appeals Department.
• Review and mailings of all Adverse Benefit Determination Letters and Appeal Letters.
• Assist with meeting minutes, data review, and appeal file maintenance.
• Finalize adverse benefit determination notification letters for clinical and administrative denials.
• Ensure notification letters are sent accurately and timely.
• Assist providers, members, and other Trillium departments with technical assistance and general questions.
• Enter data in a timely manner into TBS and utilize the Denials Module for review.

Requirements

• High School Diploma or GED.
• Minimum of one (1) year clerical experience; OR Equivalent combination of higher education/experience.
• Must have a valid driver’s license.
• Must reside within North Carolina.
• Must be able to travel within catchment as required.
• Preferred: Experience with Microsoft Office suite
• Four (4) years of clerical and office management experience

Benefits

• 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