Job Description

Job Description

The Medicare Authorization Specialist is a vital part of the Member Care department, serving senior members with both accuracy and compassion. This role is responsible for validating bill details, authorizing medical bills in accordance with CHM guidelines, Senior Share processes, and Medicare regulations, and ensuring timely, accurate service.

This individual must be able to work both independently and collaboratively, demonstrate strong attention to detail, and uphold CHM’s Core Values and Mission Statement at all times.

WHAT WE OFFER

• Compensation based on experience.
• Faith and purpose-based career opportunity!
• Fully paid health benefits
• Retirement and Life Insurance
• 12 paid holidays PLUS birthday
• Lunch is provided DAILY.
• Professional Development
• Paid Training

PRIMARY RESPONSIBILITIES

• Respond promptly and professionally to all correspondence and requests.
• Assist members and staff via phone and email with clarity, empathy, and efficiency.
• Validate and authorize Medicare Summary Notices (MSNs) and Explanations of Benefits (EOBs) according to standard operating procedures, CHM guidelines, and compliance standards.
• Meet defined productivity, turnaround time, and accuracy goals.
• Escalate complex or unusual issues to the Team Lead or Supervisor as appropriate.
• Maintain accurate records and ensure data integrity.
• Protect confidential member information in compliance with HIPAA and CHM privacy policies.
• Contribute to a high-quality member experience by exercising integrity, accountability, and compassion.
• Collaborate with team members and other departments to resolve issues effectively.

CORE COMPETENCIES & SKILLS

• Excellent written and verbal communication skills.
• Strong attention to detail and accuracy in data entry and validation.
• High level of integrity, accountability, and professionalism.
• Proficiency in Microsoft Word, Excel, and Outlook; ability to quickly learn new software.
• Strong organizational and time management skills.
• Problem-solving and conflict-resolution skills.
• Positive attitude, teachable spirit, and team-oriented mindset.
• Responsiveness to the needs of the team, members, and ministry.
• Ability to adapt to changing regulations and processes.
• Models CHM’s Core Values and Mission Statement.

REQUIRED QUALIFICATIONS

• High School Diploma or equivalent.
• Proficiency with Microsoft Office (Word, Excel, Outlook).
• Ability to maintain confidentiality and adhere to HIPAA standards.
• Strong organizational skills with the ability to meet deadlines.

REQUIRED QUALIFICATIONS

• High School Diploma or equivalent.
• Proficiency with Microsoft Office (Word, Excel, Outlook).
• Ability to maintain confidentiality and adhere to HIPAA standards.
• Strong organizational skills with the ability to meet deadlines.

PREFERRED QUALIFICATIONS

• Minimum of 2 years’ experience in medical billing, Medicare claims, or healthcare authorization.
• Familiarity with CMS guidelines, healthcare billing systems, or EHR platforms.
• Certification in medical billing or coding (CPC, CMRS, or similar).

WORK ENVIRONMENT & CONDITIONS

• Standard schedule: Monday–Friday, [9:00am – 5:00pm].
• Position may be onsite or remote
• Requires extended periods of computer use and telephone communication.
• May occasionally require additional hours to meet departmental needs.

About Christian Healthcare Ministries

Founded in 1981, Christian Healthcare Ministries (CHM) is a health care sharing ministry for Christians. CHM is a nonprofit, voluntary cost-sharing ministry through which participating Christians meet each other’s medical bills. The mission of CHM is to glorify God, show Christian love, and experience God’s presence as Christians share each other’s medical bills.

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