Appeals Specialist II

Trillium Health Resources

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

Posted 11/7/2026full-timeRemote • North Carolina • United StatesMid-LevelSenior💰 $56,270 - $69,898 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in managing appeals, grievances, and complaint cases within the Mental Health, Developmental Disabilities, and Substance Use services field, ensuring compliance with regulatory standards and effective resolution processes.

Highest-signal resume keywords

Case ManagementRegulatory ComplianceDocumentation AnalysisStakeholder InterviewingProvider Claims Experience

ATS Keywords

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Applicant Tracking System Keywords

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

Hard Skills

Case InvestigationResolution Letter PreparationDocumentation GatheringCase EvaluationMental Health Services ExperienceDevelopmental Disabilities Services ExperienceSubstance Use Services Experience

Certifications & Qualifications

Valid Driver’s License

Industry Keywords

Appeals ManagementGrievance HandlingComplaint ResolutionAccreditation StandardsNorth Carolina Residency

About the role

Key responsibilities & impact

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

Requirements

What you’ll need

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
Valid driver’s license
Must reside within North Carolina
Must be able to travel within catchment as required
Must be legally authorized to work in the United States without requiring sponsorship for employment now or in the future
Preferred: Experience working with provider claims, provider network, or provider sanctions
All candidates must pass a drug test as a condition of employment

Benefits

Comp & perks

Competitive benefits
Work-from-home options for most positions
Flexible work schedules with some roles with management approval
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