• Manages mid-level water damage claims by gathering information to determine liability exposure; assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level. • Assesses liability and resolves claims within evaluation. • Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract. • Manages subrogation of claims and negotiates settlements. • Communicates claim action with claimant and client. • Ensures claim files are properly documented and claims coding is correct. • May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review. • Maintains professional client relationships. • Performs other duties as assigned. • Supports the organization's quality program(s).

Role Description Our organization works with partner companies to source qualified talent for their open roles. The following position is available to Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers. If you are US military affiliated and have the required skill set, education requirements, and experience, please click the submit button and follow the next steps. - Use positive telephone service techniques; act on special Customer requests and maintain excellent Customer relations. - Act as trusted advisor and consultant to a single or multiple corporate accounts. - Act as the point of sale on all Domestic and International travel requirements, arranging both routine and complex travel for air, rail, car, and hotel accommodation, utilizing GDS. - Fulfill requests for multi-faceted travelers while adhering to applicable requirements and processes. - Provide consultative advice, solutions, and recommendations; pro-actively sell additional services for travelers (e.g., hotel and car) while ensuring adherence to Customers' travel policy and quality assurance standards. - Comply with all legal standard requirements, including mandatory training, compliance, and sanctions. - Deliver expectations on individual/shared team goals and support all business Key Performance Indicators. - Follow internal compliance and regulatory requirements for all Customers and locations supported. - Manage the end-to-end booking process through ticketing and order fulfillment, either over the telephone, via messaging, or via email or back-office systems and servicing platforms. - Operate in a telephony servicing environment accountable to key performance indicators of success, such as Customer satisfaction (CSAT) and key productivity metrics. - Operate in multi-channel (phone, email, and chat) servicing environments accountable to key performance indicators of success. Qualifications - Excellent written and oral communication skills. - Excellent telephone skills, including a professional demeanor. - Fluency and comprehension in the language requirements for the specific point of sale. - Strong listening skills and attention to detail. - Minimum 1-year experience demonstrating communication skills. - Passion for travel and experience with travel. - Solutions mindset with consultative skills. - Ability to anticipate Customer needs. - Polished delivery and excellent time management. - Quick learner with the ability to de-escalate Customer situations. - Passion for service and one-call resolution. Requirements - High school degree or equivalent (required). - College or some college degree (preferred). - One year of Customer sales and service experience (preferred). - One year of Corporate or leisure travel industry experience (required). - 1 year native GDS experience including airline ticketing (preferred). - Preferred industry recognized GDS Platforms including Amadeus, Sabre, Worldspan, Apollo, and Galileo. Benefits - Paid Training - Competitive Wages - Full Benefits (Medical, Dental, Vision, 401k and more) - Paid Time Off - Employee wellness and engagement programs

• Assist clients in the initiation of auto insurance claims, providing guidance and support through the initial reporting process • Follow up with insurance companies to check on status of claims and troubleshoot any hold ups / blockers in their processing • Gather and review all necessary documentation related to insurance claims, including accident reports, policy details, and other relevant information • Verify the accuracy and completeness of claims, ensuring they meet company and industry standards • Serve as a primary point of contact for clients, insurance providers, and third parties involved in the claims process. Maintain clear and timely communication to keep all stakeholders informed • Work with insurance providers to process claims efficiently and accurately, following up on any outstanding issues or discrepancies • Provide exceptional customer support to clients, addressing their questions and concerns while ensuring a seamless claims experience • Maintain detailed and organized records of claims, correspondence, and associated documentation • Assist in the resolution of claims issues, including coverage disputes, repair estimates, and settlements • Identify opportunities to enhance our claims process and provide feedback for process improvement

Role Description Trillium Health Resources has a career opening for a Claims Relations Coordinator to join our Claims team! The Claims Relations Coordinator is responsible for managing and coordinating claim issues received by providers, members, or other entities via telephone call, email, and ticket system. - Coordinate and manage calls and tickets. - Ensure claims ticket queue and call logs are updated and responded to timely. - Conduct claims research, including: - Review of claims processing system. - Review of previous and current tickets in the Claims Support Queue. - Review of paper claim logs. - Working with other claims staff to learn history. - Third party biller impacts. - Remittance Advice notifications. - Provider technical assistance. - Assist with drafting provider related communications. - Review trends of provider issues and make recommendations for updates needed in the Claims Processing System and Claims Staff training. Qualifications - High School diploma/GED with a minimum of six (6) years of experience in coordinating multiple deadlines, drafting and reviewing written correspondence, and maintaining files and/or research in a healthcare or public health setting which includes: - A minimum of six (6) years of extensive medical claims research including reviewing denials, member eligibility, communicating both written and verbally with the provider community, and analyzing claim reports. - OR Associate’s degree with a minimum of four (4) years of experience in a similar role. - OR Bachelor’s degree with a minimum of two (2) years of experience in a similar role. - 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 - Degree in Business Administration, Healthcare Administration, Human Services, Public Administration, Liberal Arts, or Humanities (preferred). - Experience in the public mental health field is highly desired due to the complexity of the work of the organization. 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.