Appeals Administrative Specialist

Christian Care Ministry is a healthcare sharing ministry for Christians that focuses on connecting people to a Christ-centered community wellness experience. The Appeals Administrative Specialist is responsible for supporting the Appeals/Grievances Department by completing clerical and administrative tasks, collaborating with team members to communicate with members and providers, and managing the appeals process.

Responsibilities

• Comply with all organizational HIPAA requirements
• Maintain am advances understanding of Medi-share program guidelines and appeals processing functions
• Acquire Medical Records for Appeals from providers
• Keep members informed of Appeals process and pray with them
• Drop conclusions from RN and LPN into Letters that are going out to members
• Set up next level of appeals for member
• Be a point of contact for member while in appeals process
• Work Faxmaker and e-mail folders
• Maintain workflow follow up in various queues
• Document medical correspondence received from members and providers
• Receive inbound and place outbound calls from/to members and providers
• Answer questions about the medical record and appeal processes
• Praying with internal and external customers as appropriate
• Contribute to the exercise and expression of the Ministry’s Christian beliefs
• All other duties as assigned

Skills

• High school diploma or GED required
• Ability to organize and prioritize daily workload
• Knowledge of medical terminology
• Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals
• Ability to write routine correspondence and reports
• Ability to speak effectively with participants, providers, and/or associates of the organization
• Ability to add, subtract, multiply and divide into all units of measure, using whole numbers, common fractions and decimals
• Ability to apply common sense understanding to carry out instruction furnished in written, oral or diagram form
• Ability to deal with problems involving several variables in standardized situations
• Skill in the use of the internet including e-mail and search engines, word processing and keyboard skills of at least 25 words per minute
• Ability to use a database system including how to update fields
• Basic knowledge of Microsoft Office (Excel, Word)
• Knowledge of a document imaging system
• Comply with all organizational HIPAA requirements
• Maintain an advanced understanding of Medi-share program guidelines and appeals processing functions
• Acquire Medical Records for Appeals from providers
• Keep members informed of Appeals process and pray with them
• Drop conclusions from RN and LPN into Letters that are going out to members
• Set up next level of appeals for member
• Be a point of contact for member while in appeals process
• Work Faxmaker and e-mail folders
• Maintain workflow follow up in various queues
• Document medical correspondence received from members and providers
• Receive inbound and place outbound calls from/to members and providers
• Answer questions about the medical record and appeal processes
• Praying with internal and external customers as appropriate
• Contribute to the exercise and expression of the Ministry's Christian beliefs
• Collaborates – builds partnerships and works collaboratively with others to meet objectives
• Interpersonal Savvy – relates openly and comfortably with a diverse group of people
• Drives Results – consistently achieves results, even under tough circumstances and tight deadlines
• Situational Adaptability – adapting approach and demeanor in real time to match the shifting demands of different situations
• Courage – ability to have tough conversations and deliver accurate advice and decisions regardless of risk or potential criticism
• Associate's degree preferred
• 1-3 years' experience preferred in Medical Administration/Medical Records

Benefits

• 100% paid Medical for employees/99% for family
• Generous employer Health Savings Account (HSA) contributions
• Employer-paid Life Insurance (3x salary) and Long-term Disability Insurance
• 6 weeks of paid parental leave (for both mom and dad)
• Dental - two plans to choose from
• Vision
• Short-term Disability
• Accident, Critical Illness, Hospital Indemnity
• 401(k) – up to 4% match on ROTH or Traditional contributions
• Generous paid-time off and 11 paid holidays
• Wellness plan including Financial, Occupational, Mental/Spiritual, and Physical health incentives up to $50/mo
• Employee Assistance Program including no cost, in-person mental health visits and employee discounts
• Monetary Anniversary Awards Program
• Monetary Birthday Awards

Company Overview