- AssistRx (Phoenix, AZ)
- …Care Providers. The Copay Support/Claims Processing Specialist will adjudication , troubleshoot claim rejections, claim reversals, allocation deficiencies, ... on enrollment discrepancies (missing info and duplicates) + Partners with claim adjudication vendors ensure proper claims processing and data integrity. + Monitor… more
- PCI Pharma Services (Philadelphia, PA)
- …track expirations, renewals, and risk indicators. **Background Check Program & Adjudication ** + Own PCI's global background check program, including vendor ... management, adjudication guidelines, and compliance with local legislation (eg, Fair...credentials. + Experience working with background screening vendors and adjudication guidelines. + Knowledge of global data protection regulations… more
- CVS Health (Baton Rouge, LA)
- …updates are operationalized. This role requires a thorough knowledge of claim adjudication , internal MAC & non-MAC related processes, and being a leader working ... with pharmacy appeal related processes and state regulations, and claims adjudication , including claims adjudication logic **Preferred Qualifications** +… more
- CVS Health (Charleston, WV)
- …do it all with heart, each and every day. As part of the Rx Claim Adjudication team, you will be expected to be proficient in all critical functions of the ... provide solutions and design complex functionality within the RxClaim application ( adjudication area) *You will positively mentor and lead assigned team projects… more
- Huron Consulting Group (Chicago, IL)
- …to support one of our clients in optimizing claims editing and adjudication processes. The ideal candidate will have deep expertise in Optum CES ... Optum CES. + Collaborate with cross-functional teams to enhance claims adjudication workflows. + Troubleshoot and resolve **system configuration issues** related to… more
- City of New York (New York, NY)
- …Finance Business Centers, City Register's Office, and the Land Records, Adjudication , and Collections divisions. Customer Operations is charged with the processing ... and excise taxes, parking fines, and Environmental Control Board summonses. The Adjudication Division is responsible for conducting hearings on all parking and… more
- Three Saints Bay (Norfolk, VA)
- …National Background Investigation Services (NBIS) or whatever new or applicable DOD adjudication system is available. + Assist the MSO in creating, maintaining, and ... National Background Investigation Services (NBIS) or whatever new or applicable DOD adjudication system is available. + Assist MSO in supporting the development,… more
- DXC Technology (Troy, MI)
- …heavy duty truck components. Responsibilities include technical troubleshooting, warranty adjudication , product support and customer support related to contacts from ... processing product warranty claims. Representatives provide technical support and warranty adjudication on heavy truck systems for an industry leading customer… more
- CVS Health (Hartford, CT)
- …into test scenarios to validate UM configuration and associated claim adjudication logic. + Trouble-shooting HRP repair edits and issues identified during ... plans and test results + 3+ years of HRP experience + Claims adjudication background + Knowledge of MedCompass and Utilization Management Configuration. + Knowledge… more
- City of New York (New York, NY)
- …Finance business centers, City Register's Office, and the Land Records, Adjudication , and Collections divisions. Customer Operations is charged with the processing ... and excise taxes, parking fines, and Environmental Control Board summonses. The Adjudication Division is responsible for conducting hearings on all parking and… more