Welcome to the start of a rewarding career on the claims-side of the long-term care industry.
We are currently recruiting individuals with a bachelor’s degree in math and/or actuarial science.
POSITION: Adjudication Specialist
START DATE: September 23, 2024
LOCATION: 100% Remote. Must reside in one of the following states shaded in blue:
*After your initial six-weeks of training, your regular shift hours offer some flexibility of when you start your day, however, your eight-hour shift must be completed by 6:00 PM ET.
Also note: Our six weeks of paid group training requires attendance every day. If you miss even one day, there is no way to catch you up.
HOURS: 8:00 am - 5:00 pm ET (7:00 am - 4:00 pm CT)*
PAY: $18.75 per hour + Medical, Dental, Vision + 401k
COMPUTER & DUAL MONITORS PROVIDED
MUST HAVE GOOD, RELIABLE INTERNET
Love a challenge
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
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
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
Eager to learn & grow
If you are a bit of a nerd and have a passion for life-long 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
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.
YOU'VE
GOT
THIS!
Starting your professional career as a Patriot RN Long-Term Care Adjudication Specialist...
...will give you an outstanding foundation and expose you to multiple facets including home health, hospice, nursing care, assisted living facilities, and more.
Caring for and serving others is what fuels our spirits and souls, and sometimes serving others happens in a behind the “behind-the-scenes” role like a Long-Term Care Adjudication Specialist.
Traditionally, long-term care insurance provide benefits to the aging and infirmed populations.
Working behind-the-scenes in the long-term care industry, you'll not only be adjudicating important financial reimbursement to a deserving population; you'll be rewarded with sound job security and true gratitude.
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 a huge financial stress taken off their shoulders.
The near-term and longer-term demand and growth for Long-Term Care is:
Multiple choice
C. Outpacing most other industry sectors
B. Mind Boggling
A. Insane
D. All of the above
A Day in the Life of an Adjudication Specialist — Open Letter
Thank you for your interest in becoming a Long-Term Care Adjudication Specialist at Patriot RN.
As an Adjudication Specialist, your day-to-day consists of three main tasks:
- Processing claims = 85% of your day
- Responding to emails = 10% of your day
- Making phone calls to facilities* = 5% of your day
*This is not a call-center position, and you will NEVER be speaking to a beneficiary.
When it comes to processing long-term care claims, the majority are straightforward and quick to resolve.
When working more challenging claims, you will use your mathematical superpowers to break down the claims and ensure you are capturing and paying the correct amounts.
Every so often, you might receive a complex claim that requires more collaborative analysis, and you will need to work through the claim with leadership and senior adjudication specialists.
What is surprising to most is that long-term care is unique to each beneficiary, and thus, each claim presents its own story.
You may need to review previous documents or communication logs to piece together missing information. You might even create an Excel spreadsheet to help break down the claim to map out the resolution. This may sound easy, but the position involves considerable self-discipline and critical thinking.
The good news is your leadership team will always be just an email or virtual meeting away to provide support and remind you that you’ve got this!
So, what does it take to be a ROCKSTAR Adjudication Specialist at Patriot RN?
The Patriot RN logo consists of three stars which represent the three key success metrics our team members must meet to be ROCKSTAR A-Players when it comes to quality.
- The first star represents our adjudication specialist’s production metric of 42 claims per day.
- The second star signifies our 98% financial accuracy metric.
- The third, and largest, star symbolizes our minimum procedural accuracy metric of 98%.
Please understand, we are not looking for an uber-perfectionist who lets a mistake derail the day.
We are looking for people who listen to feedback and want to continuously grow and become more knowledgeable.
We are looking for people who geek out over numbers, have high attention to detail, and work well independently, but also know when to ask for help.
Flip the page
ad·ju·di·cate (/əˈjo͞odəˌkāt/) verb: To make a formal judgment or decision about a problem.
Our six weeks of training are proven best-in-class in the industry to set you up for success.
In your first five weeks of training, you’ll be virtual with our amazing team leads, supervisors, and trainers (who all started as Adjudication Specialists, too.) all day and learn everything there is to know about becoming a ROCKSTAR Adjudication Specialist.
During your final week of training, you’ll work on actual claims in the morning and sync up with your trainers in the afternoon to finish out the day. Once out of training, you will have 12 weeks to conservatively ramp up to your target of processing 42 claims per day and you will find that our training provides you with everything you need to be successful in processing the majority of your claims.
Your daily routine, after you’ve settled into your work-from-home workspace, will be to review and respond to any emails you received since the end of your last work day, and then you jump right into processing claims.
Since you are working from home, email is our best form of communication. While you’ll typically receive less than eight emails a day, but the ones you get are important. Corrections and communications from our second-level audit team are communicated via email so reviewing and responding to them at the beginning and end of each day is key. You’ll carefully review each message and make the appropriate corrective action, or appeal the error.
Everyone makes mistakes, and it is expected, which is why there are a lot of policies and procedures in place to help ensure quality. The key is to take each mistake as a learning opportunity to help you improve your overall performance.
In this role, you will never contact beneficiaries directly. On occasion, you may reach out to a facility for clarification, but 90% of the time, you’ll have everything you need to accurately understand the story and process the claim.
When you are nearing the end of your shift, it is best to wrap up the claim you are working on, check and respond to any new emails, then fully log out of your system to allow for system updates.
We hope this letter has helped to explain what your day-to-day work would consist of as an Adjudication Specialist with Patriot RN. While there is much more that was not touched upon, we wanted to give you a general idea of what to expect.
If this sounds interesting because you work well independently, have high attention to detail, and critical thinking skills, you more than likely have what it takes to be a ROCKSTAR Adjudication Specialist and we would love to add you to our team!
- Danielle Mulvey
VP Operations
- Heather Hughett
Claims Supervisor
(Started as a Patriot RN Adjudication Specialist in 2016)
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Note: While this is a remote, work from home position, your schedule will be 40 hours per week, 8 hours per day, Monday through Friday during standard business hours.
As an Adjudication Specialist your position will be full-time and fully remote.
At Patriot RN, we care tremendously about the success of our employees. That’s why we’re certified as a 5-Star Employer!
As a Certified 5-Star Employer, we're committed to exclusively hiring the ideal fit (or 5-Star Employees) for every role within our organization. Our team thrives because we ensure that no one is burdened by the inefficiencies of underperforming colleagues.
When you work for a Certified 5-Star Employer, you’ll say goodbye to pulling the weight of mediocre team members and hello to team synergy and unbeatable camaraderie!
The leaders in our organization are dedicated to exclusively recruiting, hiring, and retaining 5-Star Employees. In return, our employees are dedicated, poised for success, and ready to rock their role at Patriot RN!
Step 1:
Complete Online Assessment
(Approx. 35 minutes to complete)
Step 2:
Screening Interview via Zoom
(Approx. 15 minutes)
Step 3:
Deep Dive Interview via Zoom
(Approx. 1.5 hours)
Step 4:
Skills Testing
(Approx. 20 minutes to complete)
Step 5: Background Check & Drug Screening
To verify every new employee is an ideal fit for the role of Adjudication Specialist, we take candidates through an objective hiring process comprised of just five steps.
1
2
3
4
5
illumifin roles Patriot RN Alumni have advanced to:
Claims Specialist
Team Lead
Supervisor
Trainer
Auditor
IT Development
Since 2012, more than 40 Patriot RN Adjudication Specialists have ascended to “alumni” status because they have accepted new career-advancing opportunities with our partner, illumifin, the largest third-party administrator of long-term care benefits in the industry.
“Life is not always going to go the way you expected…
Sometimes it’s going to go much, much, much better.”
-Joseph McClendon III
Alumni Quotes
What do current employees think?
"I’m thankful to have been a Patriot RN employee! As I finished my B.S. in Marketing Management, I had no idea what I wanted to do. I had worked retail, as well as construction, and I knew I wanted to use my degree for something else. When I started working for Patriot RN, I quickly fell in love with the flexible and regular schedule, and the reliable pay. The health benefits and the 401(k) options were beneficial for my family and me, as well. Although the job calls for being more independent, everyone was willing and able to help. That sort of team atmosphere certainly set Patriot RN apart from the rest, and I’m glad that I was able to be a part of it.”
Jared H.
Patriot RN Adjudication Specialist (November 2017 – August 2019)
illumifin Trainer (September 2020 – Present)
“Patriot RN gave me a start to a fulfilling career in a field I never thought I would be in. They took a chance on me when I had no background or specific education in this field. Since starting with Patriot RN, I was able to move up into a leadership position within their client company. Now I get to help teach and grow the other people Patriot RN takes a chance on. They are a fun and easygoing company to work for, and I am grateful they hired me.”
Heather H.
Patriot RN Adjudication Specialist (May 2015 – July 2016)
illumifin Claims Specialist & Team Lead (August 2017 – Present)
“I wanted to say thank you for giving me the opportunity to join the Patriot RN team, and giving me a jumpstart on my professional career. The last year working for Patriot RN has been great, and again, just want to say thank you for the opportunity.”
Damon P.
Started as Adjudication Specialist – Now a Claims Specialist for illumifin
PLEASE NOTE: Consideration for advancement opportunities are available after completing your first year with Patriot RN.
2021 Employee Engagement Survey Results
In other instances over the last decade, other Patriot RN alumni have relocated to other cities, other countries, and other positions, while other Patriot RN alumni have used their two or more years of time as a Patriot RN Adjudication Specialist to be their “day job” while they used their evenings and weekends to study and complete their licensing and/or certification exams to be an Actuary or CPA.
(BONUS for us and you…our Adjudication Specialist position is now officially a 100% remote position so you do not have to live within a 25-mile radius of our Carmel, Indiana office.)
Alumni Quotes
What do current/former employees think?
“I responded to one of Patriot RN’s job postings by sending them my resume. Shortly after, I received a prompt response from one of the hiring coordinators. Throughout the hiring process, the staff from Patriot RN was very hands-on with me. They stayed in constant communication, coaching, and encouraging me along the way. Since being hired, they have remained consistent with their helpful resources, as well as encouragement through multiple incentives.”
- Sharita Miller
Patriot RN Adjudication Specialist (February 2016 – February 2021)
“It has been awesome working for both Patriot and their client company, illumifin. Everyone from both companies has been amazing to me. I am thankful for my time here and how much it has allowed me to grow as a person. I learned so much from this job experience and plan to use it in my future jobs. It has been a pleasure working for you all.”
Maygen N.
Patriot RN Adjudication Specialist (November 2017 – July 2019)
“Upon graduating college, working with Patriot RN helped me find my place in the workforce. I have been able to work with a great team of coworkers, team leads, and supervisors who are always mindful to find the best path forward. Thanks to Patriot RN, I now feel confident that I can properly put my skills to work. Patriot RN has helped me develop as a person and an employee. Patriot RN is a great place to grow and have new experiences!”
Sam P.
Current Patriot RN Adjudication Specialist Since Sept 2017
True 100% of the time
Upset you when they are not followed
Held as very important in your life
Core values are:
Core values are not “aspirational.” (Aspirational values are defined as those that you would like to have as core values, but they’re not there yet. So please be really honest about them to yourself and with us.)
“Faking” shared core values may work during an interview and possibly through six weeks of training, but you cannot continue the rouse or feign ingenuine core values for more than 90 days.
“ABILITY
Is what you’re capable of doing.
MOTIVATION
Determines what you do.
ATTITUDE
Determines how well you do it.”
- Lou Holtz
Love a challenge
High attention to detail
Consistent
Eager to learn & grow
Honest
At Patriot RN, our team of ALL STAR, ROCKSTAR, A-PLAYER Employees all share the same core values:
“Common sense is now so rare,
having it is like having a superpower.”
-Dave Ramsey
LONG-TERM CARE INDUSTRY FACTS & FIGURES
The U.S. Long Term Care (LTC) market size was estimated at $443.2 billion in 2019 and is expected to reach $473.3 billion in 2020.
The U.S. Long Term Care (LTC) market is expected to grow at a compound annual growth rate of 6.84% from 2020 to 2027 to reach $751.9 billion by 2027.
