- Florida Atlantic University (Boca Raton, FL)
- …and support student wellbeing. + Administer Student Conduct process through adjudication of cases involving policy violations. + Interpret and ensure compliance ... with departmental and university policies, guidelines, and other relevant regulations. Educate staff and students to enforce policies. + Serve as a customer service representative of the department and university. + Maintain positive working relationships with… more
- Amazon (New York, NY)
- …constantly improve, and be a thought leader for a credit adjudication and performance monitoring platform by deploying strategic, financial, data analysis, ... and customer analytics to influence business leaders and partners. Partner with credit underwriting operations on complex credit decisions that require manual reviews or exceptions. Identify innovations and drive credit and payment experiments that provide… more
- Michigan State University (East Lansing, MI)
- …resources are available to the parties throughout the investigation and adjudication process. Representing the office through service on University committees. Other ... duties as assigned. Minimum Requirements Knowledge equivalent to that which normally would be acquired by completing a four-year college degree; three to five years of related and progressively more responsible work experience in complaint investigation,… more
- Sedgwick (Phoenix, AZ)
- …workers compensation claims to determine benefits due; and to ensure ongoing adjudication of claims within company standards and industry best practices. **ESSENTIAL ... RESPONSIBILITIES MAY INCLUDE:** + Adjusts medical-only claims and minor lost-time workers compensation claims under close supervision. + Supports other claims representatives, examiners and leads with larger or more complex claims as necessary. + Processes… more
- Epsilon, Inc (Washington, DC)
- …obtain and maintain the appropriate level of Security Clearance or Public Trust. Adjudication of the required Security Clearance or Public Trust is determined solely ... by the government. If the government determines that the candidate cannot obtain and/or maintain the appropriate level of Security Clearance or Public Trust, Epsilon will be unable to place the candidate in this position.)_ + Will be subject to a federal… more
- Beth Israel Lahey Health (Boston, MA)
- …legal requirements of pharmacy practices. 5. Understanding of insurance and adjudication processes. 6. Working knowledge of inventory processes. 7. Advanced skills ... with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web-based applications. May produce complex documents, perform analysis and maintain databases. **Preferred Qualifications:** 1. Experience in specialty… more
- MyFlorida (Gainesville, FL)
- …eligible for employment, notwithstanding suspension of sentence or withholding of adjudication . Notwithstanding this subparagraph, any person who plead no lo ... contendere to a misdemeanor involving a false statement before October 1, 1999, and who has had such record of that plea sealed or expunged is not ineligible for employment for that reason. Abide by all provisions of s. 985.644 (1), regarding fingerprinting… more
- UNC Health Care (Rocky Mount, NC)
- …reversals, adjustments, refunds or other methods. 12. Verify claims adjudication utilizing appropriate resources and applications. 13. Post payments (Insurance ... and/or Patient) and denials to patient invoices/accounts in a timely and accurate manner. 14. Reconcile accounts, research and resolve a variety of issues relating to posting of payments and charges, insurance denials, secondary billing issues, sequencing of… more
- Essentia Health (Superior, WI)
- …staff, pharmacies, third parties, and software vendors to work through claims adjudication and processing issues to ensure payment from third-party payers for ... medications ordered by Essentia providers requiring prior authorization + Understand Medicare Part B DME billing for Essentia retail pharmacies to help ensure Medicare rules are followed when processing Medicare B billed claims + Provide direct patient… more
- Dignity Health (Bakersfield, CA)
- …role responsible for the detailed and accurate processing, review, and adjudication of complex healthcare claims. This position requires expert knowledge of ... claims processing, coding, and regulatory compliance. The Claims Examiner III will handle the most challenging cases, mentor junior staff, and contribute to the development of policies and procedures. **Qualifications** **Minimum Qualifications:** + 3-5 years… more