1+ months

LPN/Medical Assistant - Medical Review Specialist (Day shift) - 168759

Louisville, KY 40202
  • Job Code
    168759

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 inclue 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 practitoner 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 confidentality 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.

PREFERRED QUALIFICATIONS: Preference will be given to candidates who have the following:

  • Leave management experience.

We're designing a better way to work, so you can achieve what you're working for. Consistently named one of the 'Most Admired Companies' by FORTUNE Magazine, and recognized by DiversityInc as one of the 'Top 50 Companies for Diversity,' ADP works with more than 740,000 organizations across the globe to help their people work smarter, embrace new challenges, and unleash their talent. "Always Designing for People" means we're creating platforms that will transform how great work gets done, so together we can unlock a world of opportunity.

At ADP, we believe that diversity fuels innovation. ADP is committed to equal employment opportunities regardless of race, color, genetic information, creed, religion, sex, sexual orientation, gender identity, lawful alien status, national origin, age, marital status, or protected veteran status. We support an inclusive workplace where associates excel based on personal merit, qualifications, experience, ability, and job performance.

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Posted: 2019-05-02 Expires: 2019-07-04

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LPN/Medical Assistant - Medical Review Specialist (Day shift) - 168759

ADP
Louisville, KY 40202

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