Compliance Specialist III

TRILLIUM HEALTH RESOURCES

$68K — $92K *
US-AnywhereRemote in North Carolina, US
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Master's degree with one year of experience in behavioral health or related field.
  • Active licensure in North Carolina as a mental health professional (LCSW, LCMHC, LMFT, LPA, LCAS, RN).
  • Valid driver's license.
  • North Carolina residency required.
  • Ability to travel within assigned catchment area.

Responsibilities

  • Conduct clinical reviews of claims to check compliance.
  • Evaluate documentation against policies and service definitions.
  • Apply clinical judgment to assess compliance and identify discrepancies.
  • Manage compliance cases from intake to resolution.
  • Investigate non-compliance allegations.
  • Determine corrective actions based on case findings.
  • Maintain case files according to regulatory standards.

Benefits

  • Flexible working hours with some remote work options.
  • No premium for employee health insurance coverage.
  • Generous PTO of 24 days and 12 paid holidays in the first year.
  • NC Local Government Retirement Pension.
  • 401k with 5% employer match and immediate vesting.
  • Quarterly stipend for remote work supplies.
Full Job Description
Pay Plan Title: Compliance Specialist III

Working Title: Compliance Specialist III

Position Number: 91503

FLSA Status: Exempt

Posting Salary Range: $68,890 - $92,138

Office Location: Remote within North Carolina

What We're Looking For

Trillium Health Resources has a career opening for a Compliance Specialist III to join our team! Compliance Specialist III performs clinical compliance reviews and evaluates prepayment claims to ensure adherence to regulatory and coverage requirements. The role applies clinical judgment to assess documentation, determine compliance, and direct corrective actions to prevent improper payments and support program integrity.

On a typical day, you might:

  • Conduct clinical reviews of pre- and post-payment claims to verify compliance.
  • Evaluate clinical documentation against coverage policies and service definitions.
  • Apply independent clinical judgment to determine compliance and identify discrepancies.
  • Manage assigned compliance cases from intake through resolution.
  • Investigate allegations of non-compliance.
  • Evaluate case findings and determine appropriate corrective actions.
  • Maintain complete case files in accordance with regulatory and accreditation standards.
  • Monitor review timelines to ensure completion within required timeframes.


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 available for some positions 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) https://www.myncretirement.gov/systems-funds/local-governmental-employees-retirement-system-lgers/lgers-handbook
  • 401k with 5% employer match and immediate vesting
  • Public Service Loan Forgiveness (PSLF) qualifying employer
  • Quarterly stipend for remote work supplies


Qualifications

Required:

  • Master's degree and one (1) year of experience with behavioral health, mental health, substance use, developmental disabilities, and/or co-occurring disorders populations or field.
  • Active North Carolina licensure as:
    • Licensed Clinical Social Worker (LCSW)
    • Licensed Clinical Mental Health Counselor (LCMHC)
    • Licensed Marriage and Family Therapist (LMFT)
    • Licensed Psychological Associate (LPA)
    • Licensed Clinical Addictions Specialist (LCAS)
    • Registered Nurse (RN)
  • Must have a valid driver's license
  • Must reside within North Carolina.
  • Must be able to travel within catchment as required.


Preferred:

  • Experience in clinical healthcare audits, monitoring, or reviews.


Deadline for Application: September 14, 2026 @ 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.

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