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Job Description Passion to problem solve utilizing multiple data sources??? LOVE MATH, but do not want to teach??? Working through your actuarial exams??? Join Our AWESOME TEAM of Long-Term Care Adjudication Specialists Full-Time (40 Hours per Week) Pay: $19.25/hour + Benefits - including medical, dental, and vision Hours: 8:00 am - 5:00 pm EST / 7:00 am - 4:00 pm CST* *After your initial six weeks of paid training, your regular shift hours offer some flexibility regarding when you start your day, however, your eight-hour shift must be completed by 6:30 PM EST. Location: FULLY REMOTE Note: This is not a call center or customer service job At Patriot RN, we pride ourselves on processing long-term care claims accurately and efficiently so we can provide important financial determinations. Working behind the scenes in the long-term care industry and the business-side of healthcare, our Adjudication Specialists process benefits to the aging and infirmed populations who depend on their claims to be accurately processed and ultimately paid. The Patriot RN TEAM is unique. Each Adjudication Specialist starts their career the same way - with an opportunity for growth. Heather was promoted to Team Lead after one year as a Adjudication Specialist at Patriot RN. Now she is a Supervisor. Megan was promoted to Team Lead after 14 months as a Adjudication Specialist at Patriot RN. Jared ascended to a Trainer with one of our client partners after two years as a Adjudication Specialist. WE ARE CURRENTLY HIRING TO BACKFILL TWO POSITIONS DUE TO PROMOTIONS. Curious about where your journey will take you? Patriot RN's Adjudication Specialist are high achievers representing the top 10% of available talent in the market. Our ROCKSTAR Adjudication Specialist are smart, detail-oriented, natural problem solvers, and want to continuously grow and become more knowledgeable. Ideal Candidate Characteristics: • Recent college graduate with B.S. or B.A. in Math or Actuarial Sciences, • Detail-oriented and highly organized - a Hermione Granger at heart!, • Eager to take on any challenge, • Self-driven with the ability to work effectively from a home office, • You work best alone because it gives you the chance to focus, • Quick with math - you don't use a calculator to figure out the tip for a $13.56 meal, • It bothers you when your friends and family are not honest about even the smallest things, • Adjudicate routine home health and facility-based claims for long-term care, • 98% Financial Accuracy, • Review and pay claims according to the claimant's policy and prescribed plan of care. Verify the provider of care is appropriate and in accordance with contract language and government regulations regarding healthcare providers and matches the plan of care for the associated dates of service, • 98% Procedural Accuracy, • Determine benefit eligibility and payable amounts based on policy language and the client's required procedures When a Long-Term Care Adjudication Specialist does their job well (with attention to detail and accuracy in determining reimbursement), a long-term care beneficiary has huge financial stress taken off their shoulders. That is why our Adjudication Specialists share the following Core Values. PATRIOT RN CORE VALUES: LOVE A CHALLENGE If shows like CSI are one of your favorite shows, and/or you love solving puzzles then you could be a great fit for our team. Peeling back layers of claims history and really doing a thorough examination of the documentation is the crux of being a Patriot RN Adjudication Specialist HIGH ATTENTION TO DETAIL If you have a gift for organization, enjoy working from lists, prefer to maintain a routine, make quality a priority, and are super focused- then we may have the dream role for you CONSISTENT If you behave the same way, have the same attitudes towards people and things every day, and work diligently to hit the bar day-in and day-out, without drama, then pinch yourself - this role is perfect for your personality! EAGER TO LEARN & GROW If you are a bit of a nerd and have a passion for lifelong learning coupled with the desire to grow professionally and personally.... BONUS TRAIT: you "geek out" over process improvement - then WOW - consider yourself lucky for finding a genuine career field. HONESTY Honesty is a virtue and the true foundational value of our team. We expect honesty about situations or events. Additionally, we also expect honest communication between colleagues and managers. Being honest allows us to take responsibility for our work, improve any areas where we may be lacking, and ask for help when necessary Benefits: Medical, Dental, Vision PTO Paid Holidays PAY: $19.25/hour Application Process: 1. Apply online, 2. Complete Online Assessment within 24 hours of application Set aside at least 35 minutes to complete the assessment, as it cannot be interrupted once it begins -- we will send you your assessment results after we have concluded our hiring to all candidates. NOTE: Our proprietary assessment helps us assure you are the ideal fit for the role because you benchmark against our existing high performers. 3. Initial Zoom interview (Approximately 15 minutes, 4. Deep Dive Interview (Approximately one hour) Apply Now: