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Christian Care Ministry · 21 hours ago

Medical Records Reviewer II/LPN

Melbourne, FL | Hybrid

Full-time

Hybrid

Entry, Mid Level

$25/hr - $34.13/hr

2+ years exp

Christian Care Ministry is a healthcare sharing ministry for Christians, dedicated to connecting people to a Christ-centered community wellness experience. The Medical Records Reviewer II utilizes clinical expertise to assess medical records against program guidelines and clinical criteria, ensuring optimal clinical outcomes for members while maintaining production goals and quality assurance standards.

Financial ServicesHealth CareNon Profit

Responsibilities

Works with leadership, clinical staff, key internal departments, and external customers to ensure optimum clinical outcomes for members

Organizes, reviews, and interprets members’ medical records and compares them against proprietary program guidelines, CMS and FDA approved policies, and evidenced-based clinical criteria as appropriate to determine eligibility for bill sharing and advocacy for additional programs and interventions; determines if the medical record documentation supports the eligibility of requested and/or billed services

Completes medical review casework as assigned and meets SLAs

Abstracts review-related data/information accurately and timely in appropriate IT systems

Provides accurate and timely submission of all administrative and review-related documents to appropriate parties

Provides appropriate consultation and referral to intra- and interdepartmental resources to ensure members receive optimum services offered by organization

Makes case presentations to medical leadership for assistance in making sharing determinations

Manages assigned clinical caseload meeting SLAs

Delivers accurate and clear verbal and written communication to internal and external customers while complying with organizational HIPAA requirements

Maintains accurate and timely records of all communications and interventions

Performs ongoing process improvement for efficiencies and effectiveness

Performs administrative and clinical processes to ensure team and departmental goals are met

Contributes to the exercise and expression of Christian Care Ministry’s Christian beliefs

All other duties as assigned

Qualification

LPN/LVN licenseMedi-Share program knowledgeClinical experienceEMR experienceAdvanced Excel skillsSalesforce knowledgeMedical terminologyData collectionAnalysisCommunication skillsOrganizational skillsCritical thinkingTeamwork

Required

Current unrestricted compact LPN/LVN license with sound knowledge of anatomy and physiology, medical terminology, and disease processes

2+ years of clinical experience and/or care coordination in an acute or med-surgical environment

1+ years working with EMRs and medical record/abstraction of data

Must be proficient in Microsoft Office and internet/web navigation and research

Expert knowledge of Medi-Share program guidelines and processes

Strong organizational, prioritization, critical-thinking, and decision-making skills

Ability to be objective, impartial, and able to adapt to change

Advanced Excel skills; intermediate Microsoft office skills (Outlook, Teams, Word)

Advanced knowledge of Salesforce, CSI/Eldorado use and documentation

Excellent computer skills – ability to access, research and use multiple software programs simultaneously for extended periods of time and keyboard skills of at least 35 words per minute

Excellent research skills to using IT systems, internet, and phone

Accurate data collection, documentation, and analysis - provide effective and efficient collection and distribution of research data without the need for supervision; able to correlate research findings with solutions

Excellent ability to communicate effectively in written, oral, telephonic, and digital formats that build collaboration and facilitate positive outcomes

Ability to work independently and effectively with a team regularly; performs assigned special projects with minimal assistance

Ability to comply with HIPAA, PHI, and all call compliance rules and regulations

Excellent ability to provide all content within a biblical framework

Preferred

Graduate from an accredited Diploma, Associates Degree, or Bachelor's Degree Program

Healthcare-related degree

Oncology experience

Experience in bill coding and medical record reviews

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

Christian Care Ministry

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.

Founded in 1993

Melbourne, Florida, USA

501-1000 employees