- Elevance Health (AL)
- …Specialist II** is responsible for the discovery, validation, recovery, and adjustments of claims overpayments. May do all or some of the following in relation to ... state regulations. + Analyze comprehensive data sources such as COB Smart, HEW, claims , and membership data to verify coverage and resolve discrepancies. + Maintain… more
- LA Care Health Plan (Los Angeles, CA)
- Payment Integrity Nurse Coder RN III Job Category: Clinical Department: Claims Integrity Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ... in the application of medical and reimbursement policies within the claim adjudication process through medical record review for Payment Integrity and Utilization… more
- Family Dollar (Chesapeake, VA)
- …associate interviews; Analyzing data from various internal systems; Case adjudication ; Proposing corrective action based on investigation findings; Production of ... and Religious accommodations. + Investigate Department of Labor Wage and Hour claims , analyze data from various internal systems, provide the Company's formal… more
- UIC Government Services and the Bowhead Family of Companies (Springfield, VA)
- …to support our customer on the TSA Personnel Security Adjudication (PERSEC) Services contract. **Responsibilities** * Receives completed fitness pre-appointment ... of relevant experience. * Extensive working understanding of the Adjudication process. Physical Demands: + Must be able to...characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq.,… more
- MyFlorida (Miami, FL)
- …records management activities relating to Social Security and Medically Needy disability claims . This includes receipt from the Social Security field offices and ... Department of Children and Families (Medically Needy cases), reviewing claims that are initialized through the automated claims process, initial review,… more
- MyFlorida (Tallahassee, FL)
- …issues and the chargeability of employer accounts for benefit payments on claims . This may be accomplished telephonically, through written correspondence, or through ... of first payments when potential issues are detected on initial or additional claims . This is accomplished through tracking the assigned claim load and utilizing the… more
- MyFlorida (Fort Lauderdale, FL)
- …issues and the chargeability of employer accounts for benefit payments on claims . This may be accomplished telephonically, through written correspondence, or through ... of first payments when potential issues are detected on initial or additional claims . This is accomplished through tracking the assigned claim load and utilizing the… more
- MyFlorida (Orlando, FL)
- …Specialist position in the Department of Commerce's Reemployment Assistance Programs Adjudication Unit. Job duties revolve around providing quality customer service ... applying laws and policies to determine the eligibility of reemployment assistance claims using the CONNECT system. This includes gathering claimant and employer… more
- GAP Solutions Inc (Arlington, VA)
- …requirements of DOHA's other Divisions (Department Counsel, Hearing Office, Appeal Board, Claims Division, and Woodland Hills) + Receive reports for adjudication ... DOHA web-based case tracking system. + Read and analyze reports for adjudication to determine whether scope of investigation meets specific DOHA investigative… more
- Executive Office for US Attorneys and the Office of the US… (Hammond, IN)
- …Security Requirements: Initial appointment is conditioned upon a satisfactory preemployment adjudication . This includes fingerprint, credit and tax checks, and drug ... testing. Continued employment is subject to a favorable adjudication of a background investigation. Probationary Period: If selected, you may be required to complete… more