Who We AreZion HealthShare is a nonprofit medical cost-sharing program that provides an organized structure for members to contribute toward each other's medical costs. We offer individuals and organizations across the country an affordable alternative to insurance; this provides peace of mind. Our goal is to be America's leading HealthShare. We strive to meet our members' needs on a personal level by following our core values: inclusive, transparent, simple. Everything we do for our members is to ensure they feel respected and to let them know we truly care about their needs.Essential Duties and Responsibilities:· Evaluate all Medical Need Submissions received from members to determine eligibility for sharing into medical expenses.· Communicate effectively and consult with members, providers, and team members as necessary throughout the determination process.· Keep members and providers informed and updated about medical needs through regular verbal and written communication.· Act with a sense of urgency in making determinations on medical needs.· Maintain HIPAA compliance and company compliance policies.· Takes inbound and outbound phone calls from members and providers regarding questions or concerns with the eligibility determination.· Providers support to email inbox management· Assists with requests and following up on obtaining medical records.· Continuously strive to exceed member expectations ensuring a high level of member satisfaction.· Provide recommendations to the Zion HealthShare Member Guidelines as needed.Required Skills and Abilities:· Minimum - Active Utah Medical Assistant (MA) license· Professional level of written and verbal communication that demonstrates directness, compassion, and empathy.· Microsoft Office Suite Proficiency· Ability to read and interpret medical records.· Ability to work effectively within a team.· Sincere desire to help other people.· Time Management· Attention to detail.Education:· High school diploma· Minimum Requirement - Utah Medical Assistant (MA) licensePhysical Requirements:· Sit for up to 8 hours a day and look at dual computer screens.· Type on a keyboard at a minimum of 45 WPM.Experience preferred:· 3+ years relevant medical records and medical terminology experience· Working knowledge of healthcare industry, policies, and guidelines· Experience working with and interpreting medical bills, statements, receipts, and medical records.· Familiarity with HIPAA.· Experience or familiarity in working from a CRM (Customer Relationship Management) system.· Spanish SpeakingBenefits:· Medical, dental, and vision insurance· 401(k) plan with company match· Paid time off (PTO)· Short-term disability insurance· Life Insurance· Paid holidaysCompensation:$22.00 per hour | $23.00 per hour after 60-day trainingJob Title: Determination AdjudicatorWork Location: 1141 W Silicon Way, Suite A. St. George, UT 84770Work Status: Full-time, exemptHours of Operation: 7:00 AM - 5:00 PMJob Posted by ApplicantPro