Claims Director

Trillium Health Resources

Claims Director providing leadership and management for the Claims Department at Trillium Health Resources. Responsible for processing claims and managing Medicaid services in North Carolina.

Posted 5/28/2026full-timeRemote • North Carolina • 🇺🇸 United StatesLead💰 $87,652 - $117,232 per yearWebsite

About the role

Key responsibilities & impact

Provide leadership, direction and management of the department
Gather, research and analyze various data to aid Executive Management in decisions regarding provider services
Ensure the identification of Medicaid and state funded covered services including retroactive Medicaid coverage to ensure appropriate enrollment and claims payment
Interact with providers and department staff to address any enrollment, payment and billing issues
Assist in ensuring that reimbursement tables in the claim’s software remain current
Develop and implement solutions for claims management

Requirements

What you’ll need

Bachelor’s degree and three (3) years’ experience with extensive medical claims filing, coding, data reporting, and financial analysis.
Knowledge of Professional (Form CMS1500) and Institutional (UB04) billing forms, ICD-10/CPT/HCPCS coding/CAQH, HIPAA and claims processing.
Must have a valid driver’s license.
Must reside within North Carolina.
Must be able to travel within catchment as required.
Preferred: Degree in Business field and/or Master’s degree
Supervision of two (2) or more employees
Experience with NC Medicaid
One or more of the following: Certified Professional Coder (CPC), Certified Coding Associate (CCA), Certified Outpatient Coder (COC) & Certified Inpatient Coder (CIC), Certified Risk Adjustment Coder (CRC), Certified Coding Specialist (CCS)

Benefits

Comp & perks

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

ATS Keywords

✓ Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

medical claims filingcodingdata reportingfinancial analysisICD-10 codingCPT codingHCPCS codingclaims processingreimbursement tables managementprovider services analysis

Soft Skills

leadershipdirectionmanagementproblem-solvingcommunicationinterpersonal skillsanalytical skillsteam supervisiondecision-makingcollaboration

Certifications

Certified Professional Coder (CPC)Certified Coding Associate (CCA)Certified Outpatient Coder (COC)Certified Inpatient Coder (CIC)Certified Risk Adjustment Coder (CRC)Certified Coding Specialist (CCS)