Independence Blue Cross · 2 months ago
Inter-Plan Relationship Coordinator
Philadelphia, Pennsylvania
Full-time
Onsite
Mid LevelIndependence Blue Cross is a healthcare company, and they are seeking an Inter-Plan Relationship Coordinator. This role involves resolving complex provider claims issues, collaborating with various teams to ensure compliance, and acting as a liaison between IBX and partner BCBS Health Care Plans.
Health CareHealth InsuranceInsuranceMedical
Responsibilities
Resolves common, complex and escalated issues directly impacting IBX Out-of-Area (HOST) provider claims by working with other BCBS Health Care Plans or directly with internal business teams
Tracks issues, provides root cause analysis and escalates to Management enabling issues to be addressed at a National level
Partners with all areas of company, especially the various IBX provider teams to achieve timely issue resolution and compliance with other BCBS Health Care Plans’ benefits requirements
Takes ownership of resolving a partner plan inquiry from start to completion, including when an issue requires assistance of another internal area
Acts as a liaison between IBX and all partner BCBS Health Care Plans to ensure end to end resolution of issues for all claims in accordance with the Inter-Plan Program (IPP) requirements
Identifies and aids in establishing business requirements for system updates/changes to eliminate “operational” issues that are identified as trends/patterns of untimely, inaccurate, non-compliant or inconsistent claims adjudication for our participating providers or partner BCBS Health Care Plans involving multiple system and inquiry platforms
Collects information related to issues and provides recommendations for educational material for the IBX provider community, especially where it concerns Host claims policies and processing
Able to effectively use Internal reporting tools to manage, analyze, and perform trend analysis of open and closed inventory both onsite and offsite to meet stringent BCBS Association requirements
Receives tracks and research Director level and above escalations for timely resolution in accordance with BCBSA escalation guidelines
Demonstrated leadership, information driven decision-making, problem solving, organization and planning skills are essential to be successful in this position
Effective presentation and communication skills, both oral and written are essential
Ability to interact effectively with Providers/Partner Plan Staff at all levels and IBX associates at all levels, and across all departments
Must be able to work efficiently in a team environment as well as individually
Qualification
Required
Demonstrated leadership, information driven decision-making, problem solving, organization and planning skills are essential to be successful in this position
Effective presentation and communication skills, both oral and written are essential
Ability to interact effectively with Providers/Partner Plan Staff at all levels and IBX associates at all levels, and across all departments
Must be able to work efficiently in a team environment as well as individually
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app
Company
Independence Blue Cross
The leading health insurer in southeastern Pennsylvania. It is a sub-organization of Independence Blue Cross.
Founded in 1938
5001-10000 employees
Funding
Current Stage
Late StageLeadership Team
Alexandra Jorgensen
Senior Vice President Human Resources
Joe Geist
SVP & Market President, National
Recent News
Home Health Care News
2026-01-14
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