Manager, Claims Administration Call Center

We are seeking a Manager for our Claims Administration Call Center 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 Manager, Claims Administration Call Center is responsible for overseeing the daily operations of the call center to ensure efficient and effective handling of insurance claims inquiries and processing. The Manager, Claims Administration Call Center, is responsible for the guidance and direction of the staff within the Claims and Call Center Department. The Manager will provide leadership to enable the staff to meet departmental and company goals.

Minimum Qualifications:

• High School diploma/GED required
• Strong knowledge of claims processing and insurance terminology.

Preferred Qualifications:

• Associate's or Bachelors degree
• Prior Supervisory experience preferred
• Experience with call center technology platforms such as CRM and workforce management software.

Responsibilities:

• Control distribution of claims to examiners to meet processing / production goals.
• Ensure timely and accurate claim processing; assist with claim processing, as necessary.
• Prepare management reports relating to production and quality; provide feedback to staff. Review quality statistics / trends; coordinate efforts with the Quality Assurance Department to implement necessary steps for improvement.
• Monitor written and telephone inquiries to ensure responses are sent accurately and timely. Monitor correspondence activity and daily forecasting methodologies to meet departmental and client specific goals and objectives.
• Monitor production of agents with regards to daily written correspondence activity, quality of service, and consistency of information.
• Support the department with strategic goals, implementation of new business and state/client audit reviews.