Appeals Administrative Specialist

Christian Care Ministry•Melbourne, FL

5d•$17 - $22•Onsite

About The Position

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.

Requirements

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
High school diploma or GED required
1-3 years’ experience preferred in Medical Administration/Medical Records
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.

Nice To Haves

Associate’s degree preferred

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

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