Christian Care Ministry

Advocate

• Collaboration with the Member Advocate
• Receive balance-bill cases from the Member Advocate following intake, eligibility verification, and pathway determination; review the case file for completeness before initiating negotiation
• Coordinate with the assigned Member Advocate on member context, prior provider communications, and any sensitivities that should shape negotiation tone or approach
• Provide settlement updates and projected closure timeline to the Member Advocate on a defined cadence so the Advocate can keep the member informed within SLA windows
• Hand back to the Member Advocate at settlement for member confirmation, CSAT capture, and case closure in the case management system
• Research Medicare, market benchmarks, and applicable fee schedules to develop negotiation strategy and opening offers for each case
• Review provider claims for CPT/ICD coding accuracy, and billing reasonableness prior to negotiation; flag suspected coding errors or upcoding for Paralegal review when warranted
• Prepare a documented negotiation plan for each case identifying opening offer, target range, walk-away threshold, and supporting evidence
• Conduct direct payment negotiations with the provider or facility that issued the balance bill to the member, on the member’s behalf
• Manage the full negotiation lifecycle: provider outreach, counter-offer cycles, settlement execution, and case closure
• Operate within Negotiator-defined settlement authority thresholds; obtain Advocacy Team Manager authorization for settlement parameters that exceed those thresholds
• Where the case has been routed through delegation, partner with the delegated team or assume internal handling per the established hand-off criteria; ensure no duplicative provider outreach
• Document all negotiation activity, communications, and settlement terms in the case management system in real time and to audit-ready standards
• Maintain accurate, current case status so that the Member Advocate, Manager, and any delegated vendor can rely on a single source of truth for the case
• Collaborate with paralegals on legal case file preparation for complex, high-dollar, or multi-party negotiations
• Escalate unresolvable cases to the Advocacy Team Manager and coordinate transition to alternative dispute resolution, third-party arbitration, or external legal counsel as authorized
• Coordinate with Claims, Network Management, or Provider Relations when a negotiation reveals a contracting, configuration, or claim-processing issue requiring upstream correction
• Identify recurring provider billing patterns and report systemic issues to the Advocacy Team Manager for network-level correction
• Maintain current knowledge of applicable state balance billing law and the organization’s sharing program guidelines as they affect provider negotiation strategy
• Contribute lessons learned and successful negotiation tactics back to the team’s playbook and training materials
• Contribute to the exercise and expression of Christian Care Ministry’s Christian beliefs
• All other duties as assigned

Member Advocate – Negotiator

• The Member Advocate Negotiator works in close partnership with the Member Bill Advocate to resolve balance bills by engaging and negotiating directly with the provider or facility that issued the bill to the member.
• The Negotiator applies knowledge of Medicare reimbursement rates, market benchmarks, payer-provider fee schedules to anchor and advance negotiations toward a settlement that protects the member from unexpected out-of-network charges.
• The role owns the full negotiation lifecycle from case assignment through settlement execution and case closure.
• At lower activation scenarios, the Negotiator’s significant spare capacity supports provider contracting and network analytics.
• Hand back to the Member Advocate at settlement for member confirmation, CSAT capture, and case closure in the case management system.

Human Resources

• Enter and maintain data in all systems that are used by CCM’s HR department
• Extract confidential employee documents from HR systems, update to preferred naming convention, and import documents into HR system.
• Assist in responding to basic candidate and employee inquiries relating to employment opportunities, training opportunities, and other HR-related questions
• Prepare and maintain candidate/employment records
• Provide basic reports and status updates to HR Leadership regularly
• Provide basic technical support as needed
• Support the HCM implementation project as needed
• Contribute to the exercise and expression of the Ministry’s Christian beliefs
• All other duties as assigned

Temporary HR Assistant

Customer Support

• Support members as primary point of contact with providers in obtaining required medical records – including providing and receiving written and telephone communication
• Serve as primary point of contact with members in obtaining authorizations
• Work directly with providers to obtain refunds on inaccurately shared bills
• Effectively communicate guidelines to providers to retrieve necessary information and guide parties through established processes/procedures
• Forward, send, and/or label incoming documentation (i.e. forms, medical records, authorizations, legal, etc.) when applicable – providing accurate and detailed case notes in accordance with established processes
• Handle multiple cases and document appropriate notes & status in required billing system (i.e. SalesForce, CSI)
• Review reports to determine if cases need to be opened and worked by other internal team members
• Assess cases within queues, sending them to appropriate areas to work/review
• Keep leadership informed of high risk/high dollar cases
• Offer to pray with providers and members on every call
• Contribute to the exercise and expression of Christian Care Ministry’s Christian beliefs
• All other duties as assigned

Christian Care Ministry

Member Advocate – Negotiator

Member Advocate – Negotiator

Temporary HR Assistant

Customer Care Specialist – Cost Management

Customer Care Specialist – Cost Management