- Elevance Health (Seattle, WA)
- …of basic prescriptions, handling medication access issues, and troubleshooting adjudication concerns. This role emphasizes problem-solving, communication, and member ... advocacy. **How you will make an impact:** + **Member Support** : Serve as the primary contact for members experiencing medication access issues, providing empathetic and knowledgeable assistance. + **Troubleshooting and Prior Authorization** : Identify and… more
- Sedgwick (Austin, TX)
- …related financial implications, along with financial implications. To ensure ongoing adjudication of claims within company standards and industry best practices; and ... to identify subrogation of claims and negotiate settlements. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Utilizes special account instructions to obtain individual customer information and adhere to instructions; identifies, initiates, and coordinates… more
- RTX Corporation (Tucson, AZ)
- …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… more
- Elevance Health (St. Louis, MO)
- …law._ The **Claims Auditor I** is responsible for pre and post payment and adjudication audits of high dollar claims for limited lines of business, claim types and ... products including specialized claims with appropriate guidance from management and peers. **How you will make an impact :** + Performs audits of high dollar claims. + Ensures claim payment accuracy by verifying various aspects of the claim including… more
- RTX Corporation (Tucson, AZ)
- …of our products. 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 **This position is an onsite role at either our… more
- RTX Corporation (Goleta, CA)
- …**Clearance Information:** This position requires 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 RTX Corporation is an Aerospace and… more
- Air Mobility Command (Goose Creek, SC)
- …and in writing. Condition(s) of Employment: Successful completion and favorable adjudication of applicable background investigation (Tier 1 Level) is required. ... Education Some federal jobs allow you to substitute your education for the required experience in order to qualify. This position DOES NOT allow for education substitution. FOREIGN EDUCATION: Education completed in foreign colleges or universities may be used… more
- State of Massachusetts (Holyoke, MA)
- …professional experience in social work or social casework, claims adjudication , job placement, recruitment, employment counseling, vocational or rehabilitation ... counseling, credit investigation, educational counseling, legal advocacy, or legal counseling. SUBSTITUTIONS: - A Bachelor's or higher degree may be substituted for two years of the required experience on the basis of two years of education for one year of… more
- CVS Health (Richardson, TX)
- …works closely with other technical leaders of the myPBM space & Claims Adjudication team to assess business goals, strategic objectives and to build a comprehensive ... and achievable multi-year roadmap for the the myPBM teams. This role will be expected to collaborate very closely with Business Stakeholders, Value Pool Product Managers/Owners and Engineering teams in different development environments. They will work closely… more
- Sedgwick (Charlotte, NC)
- …general liability claims to determine benefits due; and to ensure ongoing adjudication of claims within company standards and industry best practices. **ESSENTIAL ... FUNCTIONS and RESPONSIBILITIES** * Handles lower-level liability and/or physical damage claims under close supervision. * Supports other claims representatives, examiners and leads with larger or more complex claims as necessary. * Processes general liability… more