U.S. Department of Homeland SecuritySEVP Appeals Adjudicator U.S. Department of Homeland SecuritySEVP Appeals AdjudicatorVienna, VA$143,913–$187,093 / yearYou qualify for the GS-14 grade level if you possess one (1) year of specialized experience at the GS-13 grade level or equivalent performing duties such as: Supporting the Student and Exchange Visitor Program (SEVP) adjudication process or the SEVP Appeals Process by reviewing SEVP petitions and/or appealed decisions, researching references provided in supporting documentation by the petitioners, drafting and issuing decisions which either grant or deny petitions or which affirm, overturn, and/or remand cases which are appealed; Reporting to one of the following related to adjudication of petitions or appeals of those petitions: the Chief of the School Certification Unit (SCU), the Chief of the Analysis and Operations Center (SAOC), or the Final Appeals Authority (FAA) for all guidance and direction; Leading special project teams related to SCU/SAOC petition adjudication or SEVP appeals adjudication functions comprised of lower graded staff; and. The Department of Homeland Security encourages persons with disabilities to apply, to include persons with intellectual, severe physical or psychiatric disabilities, as defined by 5 CFR 213.3102(u), and/or Disabled Veterans with a compensable service-connected disability of 30 percent or more as defined by 5 CFR 315.707.
Infosys LtdWarranty Claims Adjudicator Infosys LtdWarranty Claims AdjudicatorPeoria, ILUtilizing innovative business excellence frameworks, ongoing productivity improvements, process reengineering, automation, and cutting-edge technology platforms, Infosys BPM enables its clients to achieve their cost reduction objectives, improve process efficiencies, enhance effectiveness, and deliver superior customer experience. Infosys BPM Limited, a wholly owned subsidiary of Infosys Limited (NYSE: INFY), provides end-to-end transformative business process management (BPM) services for its clients across the globe.
State of OklahomaAdjudicator State of OklahomaAdjudicatorOklahoma City, OKAbility to deal effectively and courteously with people, exercise good judgment in evaluating eligibility requirements, exercise good management in evaluating case management situations, interpret state and federal laws and regulations pertaining to veterans programs, social services, and employment and training activities, understand economic trends, social service programs, and psychology, anticipate, identify and resolve problems, prepare basic reports, analyze and resolve complex situations, perform highly independent work, make independent decisions. Knowledge: Current economic and social problems, human relations, community and social service providers, principles of interviewing, social assistance requirements, applicable laws, rules and policies, one-stop workforce initiatives, U.S. Department of Labor one-stop workforce initiative as it pertains to the collaboration of numerous partners providing employment supportive core services to enhance Oklahomas workforce, laws and regulations of public employment service, unemployment compensation, job training, and social services programs.
Xcelerate Solutions LLCPersonnel Security Analyst / Adjudicator - Mid w/ TS/SCI with FSP Xcelerate Solutions LLCPersonnel Security Analyst / Adjudicator - Mid w/ TS/SCI with FSPMcLean, VAResponsibilities: Advanced Case Management: Effectively manage a caseload of over 80 cases in parallel stages of processing, while maintaining the required 23 completed cases per month average. Minimum Requirements: Education/Experience: Bachelor's degree + 3 years of relevant experience OR High School Diploma/GED + 5 years of relevant experience.
Xcelerate Solutions LLCPersonnel Security Analyst / Adjudicator - Senior w/ TS/SCI with FSP Xcelerate Solutions LLCPersonnel Security Analyst / Adjudicator - Senior w/ TS/SCI with FSPMcLean, VAMinimum Requirement: Education/Experience: Bachelor's degree (in a related study) + 5 years of relevant experience OR High School Diploma/GED + 7 years of relevant experience. The Senior Security Analyst is a subject matter expert who independently applies ICD 704 and EO 12968 to the most complex cases involving significant derogatory information.
Xcelerate Solutions LLCPersonnel Security Analyst / Adjudicator - Junior w/ TS/SCI with FSP Xcelerate Solutions LLCPersonnel Security Analyst / Adjudicator - Junior w/ TS/SCI with FSPMcLean, VAResponsibilities: Case Management: Manage a varied caseload of minimally complex cases; maintain a production average of 23 completed cases per month. Minimum Requirement: Education/Experience: Bachelor's degree + 1 year of relevant experience OR High School Diploma/GED + 2 years of relevant experience.
State of WashingtonNewL&I Workers' Compensation Adjudicator 4/Trainer State of WashingtonL&I Workers' Compensation Adjudicator 4/TrainerTumwater, WA$64,776–$87,048 / yearThe Workers' Compensation Adjudicator 4 (WCA 4), within the Claims Training unit, reporting to the Claims Training Supervisor, is responsible for developing, updating, and delivering training for newly hired support staff and adjudicators in Claims Administration. Full-time employees who work full monthly schedules qualify for holiday compensation if they are employed before the holiday and are in pay status for at least 80 nonovertime hours during the month of the holiday; or for the entire work shift preceding the holiday.
Loma Linda University Medical CenterClaims Adjudicator Sr Loma Linda University Medical CenterClaims Adjudicator SrRedlands, CAAble to communicate effectively in English in person, in writing, and on the telephone; think critically; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve; recall information with accuracy; pay close attention to detail; work independently with minimal supervision. Knowledge and Skills: Extensive experience in health insurance claims processing, HMO claims or managed care environment is required, in-depth knowledge of medical billing and coding, knowledge of health insurance, HMO and managed care principles.
NAPHCARE, INC.Senior Claims Adjudicator NAPHCARE, INC.Senior Claims AdjudicatorBirmingham, ALResponsibilities for Senior Claim Adjudicator: Utilize claims processing experience and working knowledge of Medicare and Medicaid to effectively and efficiently process claims for payment while adhering to internal deadlines. If you would like to speak with our Talent Acquisition team to learn more about this position and NaphCare, please first apply directly to this position to initiate the application process, and then please send your resume to jerry.hughes@NaphCare.com where we will be in touch.
State of WashingtonL&I Workers' Compensation Adjudicator 2/ Claim Manager Apprentice State of WashingtonL&I Workers' Compensation Adjudicator 2/ Claim Manager ApprenticeTumwater, WA$54,504–$73,284 / yearRequired: One year of experience working with insurance claims within Labor and Industries or in claims/insurance adjusting, claims investigations, paramedical occupations, disability management, claims risk management/loss control, medical billing or paralegal services with experience in personal injury or medical insurance, or related fields. Full-time employees who work full monthly schedules qualify for holiday compensation if they are employed before the holiday and are in pay status for at least 80 nonovertime hours during the month of the holiday; or for the entire work shift preceding the holiday.
NorwescapNewSenior Adjudicator NorwescapSenior AdjudicatorEast Brunswick, NJ$23–$26 / hourNorwescap is seeking a dedicated Senior Adjudicator who will be responsible for adjudicating applications for the Low-Income Home Energy Assistance Program, Universal Service Fund and any additional energy savings programs. Establish and maintain program participant files, prepare necessary correspondence to obtain required documentation to complete an application, and continue and modify regular and emergency assistance applications for eligibility at the time of funding.
One Federal SolutionSenior Security Adjudicator One Federal SolutionSenior Security AdjudicatorWashington, DCAs a certified Service-Disabled Veteran-Owned Small Business (SDVOSB), we pride ourselves on delivering high-performance solutions and partnering with our customers to achieve exceptional enterprise-wide outcomes. The Senior Security Adjudicator serves as a subject-matter expert responsible for adjudicating complex, high-risk, and sensitive national security cases, including appeals and exception-based determinations.
State of GeorgiaAdjudicator 2 - Settlement Division -LEP011 - State Board of Workers'' Compensation State of GeorgiaAdjudicator 2 - Settlement Division -LEP011 - State Board of Workers'' CompensationAtlanta, GAActions that may disqualify an applicant include letters of reprimand (active for 12 months after issuance date); suspension without pay or disciplinary demotion (active for 12 months from the effective date); Performance Improvement Plans (PIP) and Leave Restriction Plans (active until 12 months after the date of conclusion). High school diploma/GED and four (4) years of experience in interpreting and applying laws regarding program eligibility; or two (2) years of experience required at the lower level Adjudicator 1 (LEP010) or position equivalent.
UNITE HERE HEALTHClaims Adjudicator III UNITE HERE HEALTHClaims Adjudicator IIIOak Brook, ILRemote$23.79–$29.13 / hourActual base salary may vary based upon, but not limited to: relevant experience, qualifications, expertise, certifications, licenses, education or equivalent work experience, time in role, peer and market data, prior performance, business sector, and geographic location. This position supports the team Supervisor in meeting departmental inventory metrics based on guidelines set forth by the Claims Department Management Team and the Department of Labor.
UNITE HERE HEALTHClaims Adjudicator II UNITE HERE HEALTHClaims Adjudicator IIOak Brook, ILRemote$20.36–$24.97 / hourActual base salary may vary based upon, but not limited to: relevant experience, qualifications, expertise, certifications, licenses, education or equivalent work experience, time in role, peer and market data, prior performance, business sector, and geographic location. Evaluates diagnoses, procedures, services, and other submitted data to determine the need for further investigation in relation to benefit requirements, accuracy of the claim filed, and the appropriateness or frequency of care rendered.
VMD CorpPersonnel Security Analyst / Adjudicator – Junior with FSP VMD CorpPersonnel Security Analyst / Adjudicator – Junior with FSPMcLean, VAClearance: TS/SCI w Full Scope PolygraphLocation: Herndon, VAResponsibilities:Case Management: Manage a varied caseload of minimally complex cases; maintain a production average of 23 completed cases per month. Minimum Requirement: Education/Experience: Bachelor’s degree + 1 year of relevant experience OR High School Diploma/GED + 2 years of relevant experience.
VMD CorpPersonnel Security Analyst / Adjudicator – Mid w/ TS/SCI with FSP VMD CorpPersonnel Security Analyst / Adjudicator – Mid w/ TS/SCI with FSPMcLean, VAClearance: TS/SCI w Full Scope PolygraphLocation: Herndon, VAResponsibilities:Advanced Case Management: Effectively manage a caseload of over 80 cases in parallel stages of processing, while maintaining the required 23 completed cases per month average. Minimum Requirements: Education/Experience: Bachelor’s degree + 3 years of relevant experience OR High School Diploma/GED + 5 years of relevant experience.
VMD CorpPersonnel Security Analyst / Adjudicator – Senior w/ TS/SCI with FSP VMD CorpPersonnel Security Analyst / Adjudicator – Senior w/ TS/SCI with FSPMcLean, VAPersonnel Security Analyst / Adjudicator – SeniorThe Senior Security Analyst is a subject matter expert who independently applies ICD 704 and EO 12968 to the most complex cases involving significant derogatory information. Minimum Requirement: Education/Experience: Bachelor’s degree (in a related study) + 5 years of relevant experience OR High School Diploma/GED + 7 years of relevant experience.
Gulfside Healthcare Services, Inc.Accounts Payable Claims Adjudicator Gulfside Healthcare Services, Inc.Accounts Payable Claims AdjudicatorLand O Lakes, FLPart timeNOTE: All Gulfside Healthcare Services positions (except some Thrift Shoppe Positions) require an AHCA Level 2 Fingerprint screening for eligibility through the AHCA Florida Care Provider Background Screening Clearinghouse. Review different payors to include Medicare, Medicaid and Commercial services adherence to the contracts and timeliness guidelines.
Wayne FarmsNewBackground Adjudicator Wayne FarmsBackground AdjudicatorGeorgiaJob Summary: The Background Adjudicator owns the adjudication of background screening results across the enterprise ensuring guideline and policy adherence to drive consistent, compliant, and timely hiring decisions. This role assists in protecting the company from legal risk by aligning with Legal, HR, and Talent Acquisition to enable speed to start and a strong candidate experience.
Amentum Services IncPersonnel Security Specialist I Adjudicator Amentum Services IncPersonnel Security Specialist I AdjudicatorSpringfield, VA$27–$28 / hourPhysical Demands: While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands and fingers to handle, or feel objects, tools or controls; use fingers and hands to type or write; reach with hands and arms; talk or hear; taste or smell. The Personnel Security Specialist (PSS) completes personnel security suitability intake tasks in support of DHS Federal Protective Services (FPS), Personnel Security Division (PSD).
AmentumPersonnel Security Specialist I Adjudicator AmentumPersonnel Security Specialist I AdjudicatorSpringfield, MissouriWhile performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands and fingers to handle, or feel objects, tools or controls; use fingers and hands to type or write; reach with hands and arms; talk or hear; taste or smell. The Personnel Security Specialist (PSS) completes personnel security suitability intake tasks in support of DHS Federal Protective Services (FPS), Personnel Security Division (PSD).
WellSense Health PlanClaims Adjudicator WellSense Health PlanClaims AdjudicatorRemoteRemoteThis includes education, experience, skills, and certifications/licensure as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. It’s an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.
Molina Healthcare IncAdjudicator, Provider Claims - Remote Must reside in KY Molina Healthcare IncAdjudicator, Provider Claims - Remote Must reside in KYCovington, KYRemoteAt least 2 years of experience in a clerical role in a claims, and/or customer service setting, including experience in provider claims investigation/research/resolution/reimbursement methodology analysis within a managed care organization, or equivalent combination of relevant education and experience. Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching, investigating and ensuring appropriate resolution of claims.
Molina Healthcare IncAdjudicator, Provider Claims (must reside in Kentucky) Molina Healthcare IncAdjudicator, Provider Claims (must reside in Kentucky)Adairville, KYAt least 2 years of experience in a clerical role in a claims, and/or customer service setting, including experience in provider claims investigation/research/resolution/reimbursement methodology analysis within a managed care organization, or equivalent combination of relevant education and experience. Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching, investigating and ensuring appropriate resolution of claims.
Molina Healthcare IncAdjudicator, Provider Claims-KY-On the phone-closing shift Molina Healthcare IncAdjudicator, Provider Claims-KY-On the phone-closing shiftAdairville, KYAt least 2 years of experience in a clerical role in a claims, and/or customer service setting, including experience in provider claims investigation/research/resolution/reimbursement methodology analysis within a managed care organization, or equivalent combination of relevant education and experience. Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching, investigating and ensuring appropriate resolution of claims.
Well Sense Health Plan IncClaims Adjudicator Well Sense Health Plan IncClaims Adjudicator$18.27–$25.72 / hourThis includes education, experience, skills, and certifications/licensure as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. It's an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.
Gulfside CareerAccounts Payable Claims Adjudicator Gulfside CareerAccounts Payable Claims AdjudicatorLand O Lakes, FloridaNOTE: All Gulfside Healthcare Services positions (except some Thrift Shoppe Positions) require an AHCA Level 2 Fingerprint screening for eligibility through the AHCA Florida Care Provider Background Screening Clearinghouse. Review different payors to include Medicare, Medicaid and Commercial services adherence to the contracts and timeliness guidelines.
WELL SENSE HEALTH PLANNewClaims Adjudicator WELL SENSE HEALTH PLANClaims AdjudicatorCincinnati, OHPerforms periodic service on locomotives in accordance with company policy that includes: changing oil, turbo inspection, fueling, changing engine air and air compressor filters and greasing couplings, fittings, traction motor gears, electrical testing and repair and fuel linkage. Performs daily service of locomotive units: fuels, waters, lubricates and oils; wipes down and cleans unit/windows; checks supplies and drinking water Performs periodic and annual inspections and understands FRA regulations pertaining to inspections.
U.S. Department of JusticeAdministrative Law Judge U.S. Department of JusticeAdministrative Law JudgeArlington, VA$176,399–$209,600 / yearThe Administrative Law Judge responsibilities include, but are not limited to: Conducting administrative enforcement and rulemaking hearings in accordance with the Controlled Substances Act (CSA); Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970, as amended; and the Administrative Procedure Act (APA). The Drug Enforcement Administration (DEA) Administrative Law Judges, under the administrative supervision of the Chief Administrative Law Judge, conduct adjudicatory hearings throughout the United States in formal, contested, often complex administrative proceedings which arise under the Controlled Substances Act.
WorldStridesNewEvent Staff, Heritage Festivals - Seasonal WorldStridesEvent Staff, Heritage Festivals - SeasonalEvent Staff assist the Event Host in ensuring that the entire event runs smoothly, ensuring adherence to the schedule by adjudicators and program participants, ensuring all logistical components are being executed as directed, and ensuring a high-quality experience for all event participants. The company was founded in 1967 to provide middle school travel programs to Washington, D.C. and has grown to provide a wide range of programs for more than half a million students annually to over 100 countries around the world.