Workplace Type: Remote
Employment Type: FT
Job Location: Barberton, OH
JOB SUMMARY
The Authorization Specialist exists to support Christian Healthcare Ministries by accurately reviewing and authorizing member medical bills, needs, and incidents in alignment with CHM Guidelines. This role plays a critical part in ensuring members receive timely, consistent, and guideline-compliant determinations while upholding CHM’s commitment to accuracy, service excellence, and compassionate care.
At the highest level, the Authorization Specialist is accountable for detailed eligibility review, precise documentation, and effective collaboration to support sound adjudication decisions and a positive member experience.
PRIMARY RESPONSIBILITIES
- Review and authorize medical bills, needs, and incidents by verifying eligibility and ensuring compliance with CHM Guidelines and established authorization criteria.
- Perform detailed membership and eligibility reviews to identify key factors that impact authorization decisions and documentation accuracy.
- Enter, update, and maintain member and bill information accurately and efficiently within CHM systems to ensure data integrity.
- Collaborate cross-functionally with internal departments to research and resolve discrepancies or missing information related to authorization decisions.
- Respond to member and internal correspondence within established service timelines (24–48 hours), maintaining professionalism and clarity.
- Support service excellence and member care by demonstrating a courteous, approachable, and service-oriented demeanor in all interactions.
- Participate in ongoing training and development to build knowledge of CHM Guidelines, processes, and healthcare-related concepts.
- Uphold CHM’s mission, values, and organizational culture in daily work and decision-making.
CORE COMPETENCIES & SKILLS
- Attention to detail and accuracy
- Task management and prioritization
- Analytical review and problem-solving
- Written and verbal communication
- Computer proficiency and system navigation
- Collaboration and cross-team communication
- Time management and accountability
REQUIRED QUALIFICATIONS & CONSIDERATIONS
Education
- High school diploma or equivalent required.
Experience & Skill Readiness
- Ability and willingness to learn medical, healthcare, and CHM-specific guidelines through structured on-the-job training.
- Comfort using computers, data-entry systems, and learning new internal platforms.
- Prior experience in administrative review, healthcare support, eligibility, or billing environments is a plus but not required.
Additional Considerations
- Alignment with CHM’s mission, values, and service-oriented culture.
- Ability to work independently while remaining accountable to team standards and timelines.