ADP is hiring a Medical Review Specialist. In this position, you'll join a team of professionals who are responsible for effectively managing leaves of absences (LOA) in accordance with Family Medical Leave Act (FMLA), state, municipality and customer-defined paid and unpaid requirements.
Responsibilities include reviewing healthcare provider certification and return to work forms to evaluate appropriateness of LOA request;
make decisions in a timely and accurate manner, seeking second / third opinions or calling practitioner offices when appropriate and resolving appeals / late submissions in an appropriate manner.
We strive for every interaction to be driven by our CORE values : Insightful Expertise, Integrity is Everything, Service Excellence, Inspiring Innovation, Each Person Counts, Results-Driven, and Social Responsibility.
RESPONSIBILITIES :
- Independently interprets and administers leave of absence programs and policies in accordance with the applicable federal and state employment laws (FMLA, Paid Family Leave (NYS PFL) ADA, USERRA, Pregnancy Discrimination Act, etc.).
- Enters timely documentation in an accurate and comprehensive manner while maintaining maximum levels of efficiency and confidentiality in accordance with HIPAA guidelines.
- Prepares and disseminates articulate written and verbal communication to assorted internal and external sources.
- Participates in the peer review process to ensure that internal and external documentation meets quality standards.
- Recommends and drives improvement to department processes to gain efficiencies and / or enhance the customer experience.
- Assists in training / orientation of new staff as requested.
- Maintain strict confidentiality when working with sensitive data.
- Work independently and as a team member
- Set priorities in day to day work
- Performs other related duties as assigned.
QUALIFICATIONS REQUIRED :
- LPN / LVN License, or higher clinical designation, from an accredited program and KY licensure in good standing.
- Graduate of a Certified Medical Assistant Program : Doctor Office Setting : Minimum of one (1) year experience.
- Expert knowledge of federal and state regulations that pertain to healthcare, leaves of absence and other employer sponsored benefit programs.
- Intermediate knowledge of Microsoft Office Suite, inclusive of Outlook, Word and Excel, sufficient to develop documents and spreadsheets for tracking and archiving information.
- Basic math skills.
- Ability to make decision and judgments utilizing problem solving skills.
- Excellent understanding of medical terminology / pathology / anatomy / ICD codes / diagnosis.
- Excellent interpersonal, phone and organizational skills required.
Travel Nurse RN - Labor and Delivery - $1,779 per week
RTG Medical-Nursing is seeking a travel nurse RN Labor and Delivery for a travel nursing job in Louisville, Kentucky. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. ...
Travel Nurse RN - Psychiatric - $1,875 per week
Coast Medical Service is seeking a travel nurse RN Psychiatric for a travel nursing job in Louisville, Kentucky. Coast Medical Service is a nationwide travel nursing & allied healthcare staffing agency dedicated to providing an elite traveler experience for the experienced or first-time traveler...
Travel Nurse - Registered Nurse - TELE - Telemetry - $2063.5 / Week
FlexCare Medical Staffing is seeking an experienced Telemetry Registered Nurse for an exciting Travel Nursing job in Louisville, KY. Additionally, the review may consider the potential impact on the nurse's ability to meet licensing and regulatory requirements as mandated by relevant healthcare agen...
Travel Nurse - RN - ER - Emergency Room - $1596 / Week
Fusion Medical Staffing is seeking an experienced Emergency Room Registered Nurse for an exciting Travel Nursing job in Louisville, KY. Start your medical travel career with Fusion Medical Staffing and gain access to competitive pay packages, comprehensive benefits, corporate discounts and perks, a ...
Travel Nurse RN - Bone Marrow Transplant - $2,134 per week
Advantis Medical, the #1 rated travel nurse agency, is currently seeking an experienced BMT/Hemonc Registered Nurse (RN) for an exciting new travel job in Louisville, KY 40202. Advantis Medical is seeking a travel nurse RN Bone Marrow Transplant for a travel nursing job in Louisville, Kentucky. This...
Travel Nurse - Registered Nurse - CVICU - Cardiovascular Intensive Care Unit - $2185 / Week
Fusion Medical Staffing is seeking an experienced Cardiovascular Intensive Care Unit Registered Nurse for an exciting Travel Nursing job in Louisville, KY. Start your medical travel career with Fusion Medical Staffing and gain access to competitive pay packages, comprehensive benefits, corporate dis...
Travel Nurse RN - Labor and Delivery - $1,897 per week
Coast Medical Service is seeking a travel nurse RN Labor and Delivery for a travel nursing job in Louisville, Kentucky. Coast Medical Service is a nationwide travel nursing & allied healthcare staffing agency dedicated to providing an elite traveler experience for the experienced or first-time t...
Certified Medical Assistant, Kleinert Kutz, First shift
Minimum one year of working in a medical facility as a medical assistant and or documented evidence of externship completed in a medical office, preferred. Medical assisting duties include patient triage, vital signs, patient history, EKG, injections, and using the electronic health record. Obtain m...
Medical Surgical Registered Nurse (Relocate to Idaho)
Paid Time Off (vacation, holidays and sick days) and Medical Paid Time Off. Idaho Falls Community Hospital is looking for awesome Registered Nurses to join our Medical Surgical team!. We are committed to providing compassionate, emergency care 24 hours a day, 365 days a year. Communicates with physi...
Certified Medical Assistant-LMR, Shea Orthopedic Group, First shift
Medical assistant diploma from accredited vocational institution, or community college course in medical assisting. Minimum one year of working in a medical facility as a medical assistant and X-ray technician. A non-exempt position responsible for performing a variety of duties in the medical pract...