Hybrid Coordinator, Claims Correspondence (IDD) presso Independent Living Systems

We are seeking a Coordinator, Claims Correspondence (IDD) to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.

About the Role:

The Coordinator, Claims Correspondence (IDD) plays a pivotal role in managing and streamlining the communication process related to claims within the health care and social assistance sector. This position ensures that all correspondence regarding claims is handled efficiently, accurately, and in timely manner to support the overall claims management process. The coordinator acts as a liaison between internal teams, external providers, and members to resolve inquiries and facilitate the smooth flow of information. By maintaining meticulous records and tracking correspondence, the role contributes to compliance with regulatory requirements and organizational standards. Ultimately, this position supports the delivery of high-quality service and operational excellence in claims processing for individuals with intellectual and developmental disabilities (IDD).

Minimum Qualifications:

• High school diploma or GED required.
• Minimum of 2 years of experience in claims processing, healthcare administration, or a related field.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook).
• Ability to manage multiple tasks and prioritize effectively in a fast-paced environment.

Preferred Qualifications:

• Associate’s degree or higher preferred.
• Experience working within the health care or social assistance industry, specifically with intellectual and developmental disabilities (IDD) services.
• Familiarity with claims management software and electronic health records (EHR) systems.
• Knowledge of regulatory requirements related to healthcare claims and patient confidentiality (e.g., HIPAA).
• Post-secondary education in health administration, social work, or a related discipline.
• Demonstrated ability to improve processes and implement best practices in correspondence management.

Responsibilities:

• Manage and process incoming and outgoing claims correspondence related to IDD services, ensuring accuracy, completeness, and regulatory compliance.
• Coordinate with claims processors, healthcare providers, and members to resolve discrepancies, answer inquiries, and ensure timely resolution of outstanding issues.
• Maintain detailed records of all correspondence, prepare activity/outcome reports, and provide relevant information to cross-functional teams.
• Assist in developing and implementing correspondence protocols and best practices to improve efficiency and workflow.
• Monitor adherence to organizational policies and regulatory guidelines related to claims communication.