Appeals Administrative Specialist

Remote, USA Full-time
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 Christian Care Ministry (CCM) is a non-profit that administers Medi-Share, a healthcare sharing program where Christians come together to share each other’s medical bills. It was founded in 1993, and is headquartered in Melbourne, Florida, USA, with a workforce of 501-1000 employees. Its website is
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