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    Trillium Health Resources

    Appeals Specialist II

    Trillium Health Resources
    Full-time
    Verified Remote
    RemoteUSD 56,270 - 69,898LegalToday

    About this role

    Pay Plan Title:Appeals or Grievances Specialist II

    Working Title:Appeals Specialist II

    FLSA Status:Exempt

    Posting Salary Range:$56,270 - $69,898

    Office Location:Remote within North Carolina.

    POSTING DETAILS:

    Make an Impact

    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.

    Why Work for Us?

    Trillium believes that empowering others begins with supporting our team. We offer our employees:

    • 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

    Every day, our work changes lives – from children thriving through early intervention and school-based therapies, to adults with severe mental illness living independently and contributing to their communities.

    If you are looking for a unique opportunity to make a tangible impact on the lives of others, apply today!

    What We’re Looking For

    Trillium Health Resources has a career opening for an Appeals Specialist II to join our team! The Appeals Specialist II manages appeals or grievance cases from intake through resolution. The role investigates concerns, evaluates findings, and prepares determination communications to ensure accurate, timely resolution and compliance with regulatory and accreditation requirements.

    On a typical day, you might:

    • Manage assigned appeals, grievances, and/or complaint cases from intake through resolution.

    • Investigate cases by gathering documentation, interviewing stakeholders, and analyzing findings.

    • Evaluate case information to determine appropriate resolution and required actions.

    • Prepare and issue acknowledgment and resolution letters within required time frames.

    • Maintain complete case files in accordance with regulatory and accreditation standards.

    Employee Benefits:

    Trillium knows that work/life balance is essential. That’s why we offer:

    • 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

    Qualifications

    Required:

    • High school diploma or GED and six (6) years of experience in the Mental Health, Developmental Disabilities, and Substance Use services field; OR

    • Associate's degree and four (4) years of experience in the Mental Health, Developmental Disabilities, and Substance Use services field; OR

    • Bachelor's degree and two (2) years of experience in the Mental Health, Developmental Disabilities, and Substance Use services field; OR

    • Equivalent combination of education and experience.

    • Must have a valid driver’s license.

    • Must reside within North Carolina.

    • Must be able to travel within catchment as required.

    Preferred:

    • Experience working with provider claims, provider network, or provider sanctions.

    Deadline for Application:Tuesday, September 1, 2026 at 11:59pm

    How to Apply

    To be considered, submit your application and resume through our ADP Career Center. Your resume must include:

    • Employer name, dates of service (month/year), average hours worked per week, and essential job duties

    • Education details (degree type, date awarded, institution, field of study)

    • Licensure/certification information, if applicable

    After submission, your resume will be reviewed to ensure it meets the essential criteria for the position. You’ll be notified by HR regarding your application status as appropriate. All applicants will receive a final update once the recruitment cycle closes.

    Join our Talent Community through ADP to stay informed about future opportunities. Be sure to keep your resume updated in your profile.

    Trillium Health Resources is an Equal Employment Opportunity (EEO) employer and a drug-free workplace. All candidates must pass a drug test as a condition of employment.

    #Innovation #Technology #Careers #NorthCarolina #BehavioralHealth

    About Trillium Health Resources

    Trillium Health Resources
    Trillium Health Resources

    Trillium Health Resources is a Tailored Plan and Managed Care Organization (MCO) serving 46 counties across North Carolina. The organization manages comprehensive services for individuals with serious mental health needs, substance use disorders, traumatic brain injuries, and intellectual/developmental disabilities (IDD). Their mission is to help individuals and families build strong foundations for healthy, fulfilling lives. Trillium provides specialized managed care services that enable children to thrive through early intervention and school-based therapies, while supporting adults with severe mental illness to live independently and contribute to their communities.

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