- Sun Pharmaceuticals, Inc (Washington, DC)
- …of but not limited to, insurance verification and / or claim adjudication , physician office and outpatient billing, medical benefit procurement, understanding of ... adjudication within Commercial and Government payers, buy and bill model, Medicare, Tricare , Medicaid and National and Regional Commercial payers. Experience working… more
- Novo Nordisk Inc. (Plainsboro, NJ)
- …experience with any or all the following: financial reporting, rebate adjudication , government programs and the IRA Pharmaceutical experience preferred Working ... knowledge of US Government program related financial impacts and requirements preferred Working financial reporting knowledge of the 340B/PHS Program, entity types, CE relationships, 340B ecosystem and related stakeholders and other program requirements… more
- Florida Atlantic University (Boca Raton, FL)
- …by auditing residential education administrative processes and the enforcement and adjudication of student staff appeal procedures. + Collaborate with Contracts and ... Assignments, Facilities, Business Operations, and campus partners to ensure seamless coordination of residential services, including occupancy management, maintenance response, and move-in/move-out procedures. Campus Engagement: + Supervise the summer housing… more
- BroadPath Healthcare Solutions (Tucson, AZ)
- …care. The Senior Claims Examiner's primary function is to ensure the accurate adjudication of all complex claims for SCCIPA contracted plans. Your expertise will be ... crucial in maintaining our high standards of accuracy and efficiency in claims processing. **Compensation Highlights:** + Base Pay: $18.00 per hour + Pay Frequency **:** Weekly **Schedule Highlights:** + Training Schedule: 5 days, Monday-Friday, 8:00 AM - 5:00… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …to provide all necessary documentation required from payors to ensure accurate adjudication of claim for reimbursement. They will process claims correctly following ... contractual arrangements the Medical Practice Foundation (MPF) has with each Payor. This incumbent is expected to accurately analyze each denial received by reviewing the patient acct, the remittance codes from Explanation of Benefits (EOB) and Remittance… more
- BeOne Medicines (Emeryville, CA)
- …new or updated digital medical content including annotations, referencing, and comment adjudication , in collaboration with subject matter experts and MRC members and ... administrators. **Content Deployment & Optimization** + Ensure seamless content deployment acrossmedical channels andplatforms. + Track key performance indicators (KPIs) for content effectiveness (eg, engagement, reach, conversion)and analyzeperformance data… more
- Centers for Independence (Milwaukee, WI)
- …is desirable. + Understanding of the prescription billing process from adjudication through reconciliation is desirable. + Previous experience with pharmacy ... automation including system interfaces desirable. + Accountability & Dependability: Takes personal responsibility for the quality and timeliness of work, and achieves results with little oversight. + Attention to Detail: Diligently attends to details and… more
- US Physical Therapy (Rome, GA)
- …thoroughly document pertinent collection activity performed. + Verify claims adjudication utilizing appropriate resources and applications. + Initiate telephone ... and/or letter contact with parties responsible for reimbursement for services provided. + Edit/Update claim information to meet and satisfy billing compliance guidelines for electronic and paper claim submission. + Demonstrate knowledge of HIPAA privacy and… more
- Wipfli LLP (Milwaukee, WI)
- …knowledge in pre-authorization, pre-admission processes, denials management, claims adjudication , etc. + Provider compliance and reimbursement business process ... optimization experience including knowledge of edits, denials, holds, reimbursement, etc. + Senior living cost reporting data analysis knowledge of key performance indicators for reimbursement and national benchmarks + Experience in California and at least one… more
- Applied Research Associates, Inc. (Nashua, NH)
- …DD254s + CDSE FSO Curriculum for Possessing Facilities + TS Adjudication **COMPANY INFORMATION:** Applied Research Associates, Inc. is an employee-owned ... international research and engineering company recognized for providing technically superior solutions to complex and challenging problems in the physical sciences. The company, founded in Albuquerque, NM, in 1979, currently employs over 2000 professionals.… more
- Parexel (Bismarck, ND)
- …with experts and active contribution to site engagement. Support of Endpoint Adjudication (EA), Data Monitoring Committee (DMC), Data Safety Monitoring Boards (DSMB) ... and Steering Committees (SC) (as applicable), by presenting medical content of study to the respective committees, responding to medical questions and by ensuring good quality of data from CQM perspective. + Medical questions are responded in a timely manner… more
- CACI International (Colorado Springs, CO)
- Senior Technical Advisor - Vetting & Adjudication Job Category: Finance and Accounting Time Type: Full time Minimum Clearance Required to Start: TS/SCI Employee ... In this role, you will lead efforts to **enhance vetting and adjudication operations** , shape technical solutions, and drive process improvements that safeguard… more
- Polaris Pharmacy Services, LLC (Covina, CA)
- Adjudication Specialist Job Details Job Location Polaris Pharmacy Services of Los Angeles - Covina, CA Position Type Full Time Salary Range $18.00 - $19.00 Hourly ... need it most, we invite you to grow with us. JOB SUMMARY: The Adjudication Specialist manages a portfolio of rejected pharmacy claims, ensuring timely billing and… more
- Mass Markets (Killeen, TX)
- …expanding, industry-leading organization. We are seeking a detail-oriented and analyticalOn-SiteClaims Adjudication Specialist to join our team! If you have strong ... of experience in one or more of the following: call center, claims adjudication , insurance adjusting, or technical customer service (preferably in a high-volume or… more
- IQVIA (Durham, NC)
- …of projects as assigned by CEVA (Clinical Event Validation and Adjudication ) management, covering single or multiple CEVA functions. Provide leadership and ... and transparent program for customers in areas of endpoint adjudication committee coordination, core laboratory coordination, DSMB administration, and steering… more
- US Bank (Chicago, IL)
- …Partners with their assigned Line of Business, other Risk/Compliance/Audit (RCA) professionals, and RCA Managers to, depending on their function, create, implement, ... At US Bank, we're on a journey to do our best. Helping the customers and businesses we serve to make better and smarter financial decisions and enabling the communities we support to grow and succeed. We believe it takes all of us to bring our shared ambition… more
- Executive Office for US Attorneys and the Office of the US… (Los Angeles, CA)
- …Ana and Riverside. Initial appointment is conditioned upon a satisfactory preemployment adjudication . All initial attorney positions to the Department of Justice are ... (temporary) basis. Initial appointment is conditioned upon a satisfactory preemployment adjudication . This includes fingerprint, credit and tax checks, and drug… more
- Executive Office for US Attorneys and the Office of the US… (Minneapolis, MN)
- …Security Requirements: Initial appointment is conditioned upon a satisfactory preemployment adjudication . This includes fingerprint, credit and tax checks, and drug ... testing. In addition, continued employment is subject to a favorable adjudication of a background investigation. Residency Requirements: Assistant United States… more
- AON (NY)
- Aon is looking for a Claims Specialist II Do you have experience in claims adjudication and enjoy resolving issues for clients? If you'd like to grow your experience ... verbal and written communication. Skills that lead to success: + Claims adjudication experience. + Clear and professional written and verbal communication. + Detail… more
- Executive Office for US Attorneys and the Office of the US… (Las Vegas, NV)
- …Security Requirements: Initial appointment is conditioned upon a satisfactory preemployment adjudication . This includes fingerprint, credit and tax checks, and drug ... testing. In addition, continued employment is subject to a favorable adjudication of a background investigation. Residency Requirements: Assistant United States… more
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