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Utilize experience with Applications in Claim Adjudication: RxClaim (PBM), Facets, Claim system, AEPPYS, CRS; QA Methodologies: SDLC waterfall model, Estimation, timeline and planning; QA Tools: HP - ALM, HP - UFT, Clear Quest, JIRA; iSeries and COBOL; Databases: DB2 and IDBMS; SOAP UI; Functional testing, Regression testing, Smoke testing, Automation testing; E2E testing; Managing and leading teams in Onsite - offshore model.
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Note: A Master's Degree or equivalent 36 credit hours of post baccalaureate course work from an accredited college or university in Educational Administration, Rehabilitation Counseling, Special Education, Counseling and Guidance, Vocational Evaluation, Psychology, or in a Social Science related field may be substituted for one year of the required experience in rehabilitation or in the adjudication or processing of disability claims.
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As a Senior Manager you will be a key member of the Funds Risk Management team who is responsible for credit risk adjudication and ongoing monitoring of the. Senior Manager, Funds Risk Management - Credit Adjudication.
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Manage projects from initiation through closure for full scope regional and global projects, with activities focused on site selection, study start-up (including all systems and plan development), clinical operations, statistics and statistical programming, data management, subject randomization and drug supply management (IWRS), administration of data monitoring and/or adjudication committees, regulatory submissions, vendor management, and medical/scientific writing.
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Are you a Senior Workers Compensation Claims Adjuster/Examiner with experience working claims from receipt to adjudication? Manage claim process from receipt to adjudication (cradle to grave.
Full-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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From the Office of Coal Mine Safety in Price to the southern Utah Adjudication office in St. George, to the Commission’s HQ in downtown Salt Lake, Utah Labor Commission employees cover the state to enhance safety in Utah’s workplaces and achieve fairness in employment and housing.
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Completes all non-medical claims adjudication (Home health services, ALF, nursing Home) to include verifying claims and incidental charges, flags and researches questionable bills, prints remittance advice and check requests.
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Demonstrated understanding of cross-functional processes including site selection, study start-up clinical operations, statistics and statistical programming, data management, subject randomization and drug supply management (IWRS), data monitoring and/or adjudication committees, regulatory submissions, vendor management, and medical/scientific writing.
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Assist federal personnel security specialist in the adjudication of background investigations for suitability and fitness for employment with the government. adjudication, and compiling results of completed Background Investigations of government personnel and contract employees conducted by OPM, FBI, and other Federal investigative agencies and provide a recommendation for approval, disapproval, or referral for further investigation.
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Receive, review and assemble detailed security package for federal personnel security specialist to determination of suitability and fitness for employment. Provide a written report of data received from personnel security reports, records and investigative materials for review by federal personnel security specialist.
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Must possess a current Top Secret (TS) clearance based upon a Single Scope Background Investigation (SSBI) completed within the past five (5) years and shall also be determined eligible for access to Special Compartmented Information (SCI) by the Central Adjudication Facility (CAF) or other designated adjudication authority prior to arrival onsite.
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his role will be o serve as he primary universi y decision-maker and hearing officer for mos , if no all, cases ha involve cases inves iga ed and referred by he i le IX Coordina or alongside ano her s uden conduc professionals.
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Provide responses to requests for technical assistance or adjudication received via letter, Departure from Specification (DFS), Liaison Action Request (LAR), Steam Plant Action Request (SPAR), Availability Work Package (AWP) Change Request.
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In addition to overseeing the day-to-day operations of the Provider Data Management Department, he or she is responsible for and directs the configuration of the organization’s provider management system for the accurate and compliant adjudication of claims from the organization, Medicare and Medicaid health plans, Ryan White Care Act (RWCA) programs and wellness and prevention (sexually transmitted disease testing) programs.
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Manage design configuration including chairing the program design configuration control board (CCB) for engineering change including design integration and change adjudication with support from ESG engineering and ILS departments.
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adjudication job
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