- PNC (Brock, NE)
- …and have an opportunity to contribute to the company's success. As an Adjudication Specialist within PNC's Human Resources Operations organization, you will be ... as needed to make an employment eligibility determination. + Document adjudication determinations and communicate those determinations to internal business partners.… more
- BrightSpring Health Services (Englewood, CO)
- …through our growing network of branches and healthcare professionals. The Adjudication Specialistwill be responsible for all aspects of pharmacy and medical ... claims adjudication , accuracy of pharmacy and medical claims, resolution of third-party rejections, and coordination of benefits. SCHEDULE: Monday - Friday in… more
- ThermoFisher Scientific (Greenville, NC)
- …CEC/DSMB study start-up activities (charter development, member contracting, electronic adjudication system build) and close-out activities. + Performs day-to-day ... expert knowledge of specialty committee processes and procedures. + Reviews adjudication /DSMB publications and information sources to keep updated on current… more
- CVS Health (St. Paul, MN)
- …**Additional Responsibilities** - Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. - Applies medical ... discrepancies, and applies all cost containment. measures to assist in the claim adjudication process. - Handles phone and written inquiries related to requests for… 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
- NANA Regional Corporation (Arlington, VA)
- RiverTech is looking for a Personnel Security Specialist IV to provide adjudication support for Federal Adjudicators to make suitability and national security ... associated with a candidate to make suitability, eligibility and adjudication recommendations or determinations. + Makes recommendations in accordance with… more
- AON (NY)
- …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 ... 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… more
- Transportation Security Administration (Springfield, VA)
- …Springs, CO. The STAD Director oversees the security threat assessment adjudication and redress operations to determine whether individuals seeking access, ... results of security threat data. This data review and adjudication process includes criminal history, immigration/citizenship/lawful presence, state and local… more
- Xcelerate Solutions (Washington, DC)
- Personnel Security Specialist (PSS ) Grade 6 - TS Xcelerate Solutions is seeking a Personnel Security Specialist (PSS) Grade 6 you will support a full range of ... the Agency Personnel Security Program Managers (PSPM) in performing BIs and adjudication case work in support of security and suitability investigations and… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …Advantage, Medicare Supplement, and individual plans._** **Responsibilities** **Cash Recovery Specialist ** Reviews and research routine to moderately complex refunds ... projects, etc.). . Performs other duties as assigned. **Senior Cash Recovery Specialist ** Reviews and research moderately complex to complex refunds and returned… more
- State of Montana (Helena, MT)
- …performs a variety of duties associated with managing Montana's water resources. The Specialist works primarily with the adjudication programs in the Helena ... Regional Office. The Specialist analyzes statements of claim filed in the adjudication process, water right records, and other data sources to identify legal and… more
- KPH Healthcare Services, Inc. (Gouverneur, NY)
- …entry of new client data or changes to existing clients into the PBM adjudication platform. Translates client benefit needs into the PBM platform and all associated ... in order to effectively input, audit and adjust within the adjudication platform. **Job Summary:** Perform day-to-day operations supporting ProAct's adjudication… more
- City of Baytown (Baytown, TX)
- Property Room Specialist Print (https://www.governmentjobs.com/careers/baytowntx/jobs/newprint/4764877) Apply Property Room Specialist Salary $16.79 - $20.99 ... We are seeking a detail-oriented and organized Property Room Specialist to manage and oversee the storage, documentation, and...+ Expert 06 Have you ever been on deferred adjudication for a Felony? + Never + Yes, less… more
- National Park Service (Philadelphia, PA)
- …The primary purpose of the position is to serve as an environmental specialist assisting with the parks' environmental compliance. Open to the first 50 applicants ... Citizenship required. Appointment subject to background investigation and favorable adjudication . Meet Selective Service Registration Act requirement for males.… more
- Amentum (Washington, DC)
- …processes. + Prepare and submit a response in writing or verbally, to recommend adjudication as to the approval, denial, or revocation of security clearances and / ... authorizations for appropriate SecD units to determine the final adjudication . Prepare outgoing communications to transmit recommendations with supporting analysis… more
- AdventHealth (Altamonte Springs, FL)
- …and communicates with other departments to ensure accurate and timely claim adjudication . This position will be responsible for activities requiring a deep insight ... requests, and resubmitting corrected claims to ensure accurate and timely claim adjudication . Review explanation of benefits (EOB) or, if not present, call the… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …for our FLEX persona. The position serves as a Prepayment Review Coding Specialist within the Fraud Investigation & Prevention Unit ("FIP"). The position will be ... a dedicated coding specialist reviewing medical records to identify instances of health...process allows for claims to be reviewed prior to adjudication to ensure claims are billed appropriately and prevents… more
- Advantage SCI (Fort Meade, MD)
- Job Descriptions: Position: Personnel Security Specialist Reports To: The Customer and Project Manager Clearance Type: Active TS/SCI with CI Poly Work Location: Ft. ... Meade, Maryland Advantage SCI is seeking a Personnel Security Specialist to be considered for employment. This individual shall support the Personnel Security… more
- Navy Exchange Services (NEX) (Virginia Beach, VA)
- Title: Facilities Contract Specialist (Level I/II) Non-Competitive Progression Location: United States-Virginia-Virginia Beach Job Number: 24000464 Are you ready to ... NEXCOM is seeking driven professionals to join our team as Contract Specialist I and II roles-non-competitive, progressive positions that offer a clear pathway… more
- Advantage SCI (Reston, VA)
- Job Descriptions: Position: Personnel Security Specialist Reports To: The Customer and Project Manager Clearance Type: Active TS (with ability to obtain SCI with CI ... personnel for access to sensitive compartmented information, through case management, adjudication , and due process. * Review forms for accuracy and process… more
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