Claims Correspondence Coordinator

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.