Appeals Administrative Specialist

The range for this role is $17.07 - $21.88  

Actual base pay will be determined based on a successful candidate's work location, skills/abilities, experience, and education.

Interested applicants must be willing and able to work onsite minimum 4 times per week in either our Melbourne, FL or Orlando, FL office.

The Mission

At Christian Care Ministry we believe that Christians can, and should, share in one another’s burdens. Through the use of Medi-Share®, a healthcare sharing ministry for Christians, we cultivate that belief. To that end, our Mission Statement is as follows: Connecting people to a Christ-centered community wellness experience based on faith, prayer, and personal responsibility.

The Team

Everyone at Christian Care Ministry is in agreement with our Statement of Faith, which outlines our core beliefs. Although we aren’t perfect people, we are serving our perfect God and our Members to the best of our ability.

The Job

The Appeals Administrate Specialist is responsible for supporting the Appeals/Grievances Department by completing clerical and administrative tasks as assigned.  The responsibility of the Appeals Admin is to work collaboratively with members of the team to provide needed support in communicating with members and providers to obtain medical records and explain the appeal process and status. 

Essential Job Duties & 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 

Essential Skills & Abilities

• 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 

Core Competencies/Demonstrable Behaviors

• Collaborates – builds partnerships and works collaboratively with others to meet objectives.  This role requires a high level of internal customer interaction to meet objectives
• Interpersonal Savvy – relates openly and comfortably with a diverse group of people.  Must be able to communicate effectively and build engagement across all audiences
• 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 

Education and/or Experience

• High school diploma or GED required
• Associate’s degree preferred
• 1-3 years’ experience preferred in Medical Administration/Medical Records 

Supervisory Responsibilities

• This job has no supervisory responsibilities

Incentives & Benefits

We work hard to serve our Medi-Share Members, but know we can only do that if we invest in our employees professionally, financially, physically, socially, and spiritually. We purposefully invest in our employees so that our employees can invest in others.

For full-time employees working 30 hours or more, some of our benefits include, but are not limited to:

• 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

Minimum Age Requirement: Due to the nature of the responsibilities associated with this position—including independent decision-making, access to confidential information, and potential exposure to regulated environments—candidates must be at least 18 years of age at the time of hire. This requirement is in accordance with applicable federal and state labor laws and is intended to ensure compliance with workplace safety and legal standards.