We are seeking a Claims Correspondence Coordinator 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 Claims Correspondence Coordinator plays an essential role in managing and streamlining communication related to claims between providers clients and various departments. This position ensures that all correspondence is handled efficiently, accurately, and in compliance with regulatory standards, thereby facilitating timely resolution of claims issues, disputes and appeals. The Claims Correspondence Coordinator acts as a liaison to clarify claim statuses, respond to inquiries, and support disputes and appeals processing team by maintaining organized records and documentation. By effectively managing correspondence workflows, this role contributes to improved customer satisfaction and operational efficiency. Ultimately, the Coordinator supports the integrity and accuracy of claims processing, which is essential for the financial health of the organization and the satisfaction of its stakeholders.
Minimum Qualifications:
- High school diploma or equivalent; associate degree.
- Minimum of 2 years experience in claims processing, health care administration, or a related field.
- Proficiency with standard office software (e.g., Microsoft Office Suite) and claims management systems.
- Experience processing UB04 and CMS 1500 claims
- Ability to manage multiple tasks and prioritize effectively in fast-paced environment.
Preferred Qualifications:
- Bachelor’s degree in Health Administration, Business, or a related discipline.
- Experience working within health care insurance or claims correspondence specifically.
- Familiarity with HIPAA regulations and health care compliance standards.
- Knowledge of medical terminology and health care billing processes.
- Experience with claims adjudication software.
Responsibilities:
- Demonstrate commitment to Our Mission and models ILS Experience Standards of Excellence.
- Coordinate incoming and outgoing correspondence related to healthcare claims across multiple channels.
- Verify claim information for accuracy and route it appropriately to support timely processing.
- Respond to inquiries from providers, and insurers regarding claim status and documentation.
- Maintain organized records of all correspondence to ensure compliance and audit readiness.
- Collaborate with internal teams to resolve discrepancies, disputes and appeals and improve correspondence workflows.
- Perform other duties as assigned.
Skills Required
- High school diploma or equivalent
- Associate degree
- At least 2 years of experience in claims processing, healthcare administration, or a related field
- Proficiency with Microsoft Office Suite and claims management systems
- Experience processing UB-04 and CMS-1500 claims
- Ability to manage multiple tasks and prioritize effectively in a fast-paced environment
- Bachelor's degree in Health Administration, Business, or a related discipline
- Experience working in healthcare insurance or claims correspondence
- Familiarity with HIPAA regulations and healthcare compliance standards
- Knowledge of medical terminology and healthcare billing processes
- Experience with claims adjudication software
What We Do
Independent Living Systems, LLC, offers a comprehensive range of clinical and third-party administrative services to managed care organizations and providers that serve high-cost, complex member populations in the Medicare, Medicaid and Dual-Eligible Market. Independent Living Systems has been an industry leader in managing home and community-based programs for over 16 years. Leveraging ILS’ award winning technology platform, ILS provides assistance beyond the clinical realm at every stage of care from hospitalization to the treatment of chronic illnesses to personalized care management including nutritional support. As one of the country’s leading providers of Nutritional Support Services and medically tailored meals, ILS provides nutrition counseling and home delivered meals for individuals transitioning from acute settings to the home as well as for those combatting the effects of one or more chronic diseases. In partnership with health plans, providers, hospitals, and pharmaceutical and medical device companies, ILS provides solutions aimed at improving health outcomes while rebalancing costs. ILS’ suite of products and services include: MLTSS - Managed Long-Term Services Supports Suite of solutions including assessments, care management, and coordination of home and community-based services, care planning, and back-office support CCM - Comprehensive Care Management A streamlined solution for ongoing care management and care optimization targeted towards special needs populations and special needs plans Meals and Nutrition One of the nation’s largest nutritional providers delivering consistent, high-quality therapeutic meals to elderly and at-risk populations TPA – Third Party Administration A fully integrated business and technology offering to support all administrative and financial reporting requirements of health plans and risk bearing entities MSO – Management Services Organization Population and provider-based interventions to address utilization and monitor unit costs of services For more information please contact us via email at [email protected].
