- Molina Healthcare (Iowa City, IA)
- …results and makes recommendations as necessary. * Helps to evaluate the adjudication of claims using standard principles and state specific policies and regulations ... to identify incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and processing errors of claims. * Prepares, tracks, and provides audit findings reports according to designated timelines Presents audit findings and makes… more
- Adecco US, Inc. (Phoenix, AZ)
- …level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to ... identify subrogation of claims and negotiate settlements with general supervision. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** . Processes low level workers compensation claims determining compensability and benefits due on long term indemnity claims,… more
- RTX Corporation (Tucson, AZ)
- …cumulative GPA. + This position requires a security clearance. DCSA Consolidated Adjudication Services (DCSA CAS), an agency of the Department of Defense, handles ... and adjudicates the security clearance process. More information about Security Clearances can be found on the US Department of State government website here: https://www.state.gov/securityclearances + Tucson, AZ:… more
- Sedgwick (San Francisco, CA)
- …workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and ... to identify subrogation of claims and negotiate settlements. **ESSENTIAL RESPONSIBILITIES MAY INCLUDE:** + Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files… more
- SAIC (Chantilly, VA)
- …program requirements and cost effective. + Support the oversight of anomaly adjudication and resolution by direct fact finding, reviews, audits, inquires, and ... investigations of payload processing, testing or operational failures. Coordinate/Facilitate program office reviews and discussions with the developer, inter-office, and with externals as needed. + Coordinate with other acquisition offices to facilitate… more
- RTX Corporation (Woburn, MA)
- …Clearance Information: This position requires a security clearance. **DCSA Consolidated Adjudication Services (DCSA CAS)** , an agency of the Department of ... Defense, handles and adjudicates the security clearance process. More information about Security Clearances can be found on the US Department of State government website here: https://www.state.gov/m/ds/clearances/c10978.htm The salary range for this role is… more
- Caterpillar, Inc. (Peoria, IL)
- …Claims team to improve the Quality and Velocity of our claim adjudication . **Additional Information:** + **Location:** Peoria, IL (United States) + **Required ... Travel:** Up to 10% (Domestic + International) + **Relocation Assistance Offered:** None. + **US Work Sponsorship Offered:** None. **What You Will Do:** * Work closely with our internal partners (Global Service, Product Groups, Cat Finance) and external… more
- National Park Service (Wellfleet, MA)
- …Citizenship required. Appointment subject to background investigation and favorable adjudication . Meet Selective Service Registration Act requirement for males ... Selectee will be required to participate in the Direct Deposit Electronics Funds Transfer Program. You will be required to operate a government (or private) motor vehicle as part of your official duties; a valid driver's license is required. You will be… more
- BMO Financial Group (Chicago, IL)
- …Prospects, Bankers and Risk Management to provide expertise regarding the adjudication of applications. + Mitigates identified risks and makes credit ... recommendations/decisions in accordance with sound credit-granting principles and compliance with the Bank's philosophy and principles outlined in corporate risk policy and supporting policies and procedures. + Identifies and escalates irregularities and… more
- Centene Corporation (Tallahassee, FL)
- …the provider set-up and contract configuration to ensure accurate claims adjudication + Evaluate and monitor providers' performance standards and financial ... performance of contracts. + Assist with and track credentialing activities + Facilitate the organization of provider focus groups + Coordinate with internal departments and contracted providers to implement and maintain contract compliance + May require up to… more