26 Results for

Adjudicator Jobs in Illinois

Jobs

Claims Adjudicator II UNITE HERE HEALTH

Oak Brook, IL

Remote

$20.36–$24.97 / hour

Actual 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.

30+ days ago

Associate Vice President, Adjudication Services CVS Health Corp

Northbrook, IL

$185,400–$375,950 / year

Reporting to the Vice President, Adjudication and Client Experience Engineering, this AVP will lead a team of 500+ engineers and steward a $60M+ technology portfolio in support of Pharmacy Services outcomes across Commercial Programs, Government Services and Strategic adjudication initiatives. Proven ability to lead large-scale transformation involving core platforms, AI, cloud technologies, service-based or microservices architectures, enterprise application integration, API strategy and lifecycle management, and system interoperability.

8 days ago

Workforce Development Specialist U.S. Department of Labor

Chicago, IL

$76,463–$99,404 / year

To claim 10-point (CP/CPS, XP) preference, you must submit a copy of your DD214 and the proof of entitlement of this preference, which is normally an official statement, dated 1991 or later, from the Department of Veterans Affairs certifying to the present existence of the service-connected disability and indicating the percentage of your disability. Provides policy and programmatic guidance to internal staff, local recipients, and external stakeholders by interpreting federal and state requirements, resolving implementation issues, and promoting effective administration of Career and Technical Education (CTE) and workforce development programs.

1 day ago

Visual Information Specialist Department of the Treasury, US

Bloomington, IL

$50,460–$133,142 / year

Superior Academic Achievement - A Bachelors degree, with one of the following: A GPA of 3.0 or higher on a 4.0 scale for all completed undergraduate courses or those completed in the last 2 years of study, or a GPA of 3.5 or higher on a 4.0 scale for all courses in the major field of study or those courses in the major completed in the last 2 years of study, or rank in the upper one third of the class in the college, university, or major subdivision, or membership in a national scholastic honor society recognized by the Association of College Honor Societies. Designing, developing, and managing the execution of a wide collection of design products/projects simultaneously (in English and other languages), such as meetings/events/conference materials, social media elements, tradeshow exhibits, forms, brochures, posters, websites, single and multiple page print and digital publications, promotional displays, packaging, and signage systems for a diversified nationwide audience.

1 day ago

Tax Law Specialist Department of the Treasury, US

Bloomington, IL

$74,678–$133,142 / year

To update your application, including supporting documentation: Visit USAJOBS - How to Update Application during the announcement open period, make updates or add supporting documentation, then continue through the entire application process and click Submit Application to send updates to the hiring agency. Resolves recurring and moderately complex technical issues involving interpretation and application of tax law requirements, ensures consistency among related taxpayer products and guidance materials, and identifies operational impacts associated with reporting and compliance requirements.

1 day ago

LOGISTICS MANAGEMENT SPECIALIST United States Air Force

Scott AFB, IL

$41,769–$99,550 / year

AF DCIPS Interchange AF Internal Employee DoD Transfer Excluding Air Force EO 12721 Certain Former Overseas Employees EO 13473 Appointment of Certain Military Spouses Former Federal Employees Reinstatement Interagency Career Transition Assistance Plan Land Management Employee Military Spouse Preference Non-AF DCIPS Interchange Non-Appropriated Fund Non-DoD Transfer Other Interchange Agreements People with Disabilities Schedule APPP DoD Military Reserve MR and National Guard NG Technicians PPP DoD Retained Grade Preference Eligible PPP Mil Res MR and Nat Guard NG Pref Eligible Technician Receiving Disability Retirement Special Inspector General for Afghanistan Reconstruction. Conditions of employment Must complete initial online questionnaire and additional assessments U.S. Citizenship is required Males must be registered for Selective Service see www.sss.gov A security clearance may be required This position is subject to provisions of the DoD Priority Placement Program Position may be subject to random drug testing Employee may be required to work other than normal duty hours to include evenings weekends andor holidays Shift work and emergency overtime may be required Employee must maintain current certifications Disclosure of Political Appointments All federal employees are required to have direct deposit.

4 days ago

Manager, Personnel Background Investigations KPMG International Cooperative

Chicago, IL

$127,200–$246,900 / year

Albany, NY; Albuquerque, NM; Anchorage, AK; Ashburn, VA; Atlanta, GA; Austin, TX; Baltimore, MD; Baton Rouge, LA; Bentonville, AR; Birmingham, AL; Boise, ID; Boston, MA; Boulder, CO; Buffalo, NY; Charlotte, NC; Chicago, IL; Cincinnati, OH; Cleveland, OH; Columbus, OH; Dallas, TX; Denver, CO; Des Moines, IA; Detroit, MI; El Segundo, CA; Fort Worth, TX; Ft Lauderdale, FL; Greenville, SC; Harrisburg, PA; Hartford, CT; Honolulu, HI; Houston, TX; Indianapolis, IN; Irvine, CA; Jackson, MS; Jacksonville, FL; Kansas City, MO; Knoxville, TN; Las Vegas, NV; Lincoln, NE; Los Angeles, CA; Louisville, KY; McLean, VA; Melville, NY; Memphis, TN; Miami, FL; Milwaukee, WI; Minneapolis, MN; Montvale, NJ; Morristown, NJ; Nashville, TN; New Orleans, LA; New York, NY; Oklahoma City, OK; Omaha, NE; Orlando, FL; Philadelphia, PA; Phoenix, AZ; Pittsburgh, PA; Portland, OR; Providence, RI; Raleigh, NC; Richmond, VA; Rochester, NY; Sacramento, CA; Salt Lake City, UT; San Antonio, TX; San Diego, CA; San Francisco, CA; San Juan, PR; Santa Clara, CA; Seattle, WA; Shreveport, LA; St Louis, MO; Stamford, CT; Tallahassee, FL; Tampa, FL; Tempe, AZ; Virginia Beach, VA; Washington, DC; Winston-Salem, NC. Responsibilities: Apply comprehensive and specialist knowledge in conducting background investigation case management and adjudication programming to mitigate and minimize risks associated with personnel and third-party talent acquisition or other background related investigations of parties with trusted access to people, information, and assets in alignment to all set forth governmental, client driven, or regulatory obligations.

4 days ago

Supervisory IT Specialist U.S. Department of Veterans Affairs

$125,776–$163,514 / year

SELECTIVE PLACEMENT FACTOR: In addition to the minimum qualifications described above, you must meet the following requirement(s) to be considered qualified for the position: Within the past five (5) years, the applicant has served as the program lead or senior technical authority for a mission-critical, high-availability enterprise system deployed in a cloud environment, built on an enterprise application stack that includes a Java-based application, a relational database, and one of more data replication, synchronization, or messaging mechanisms, with direct ownership of system sustainment data integration or synchronization with a partner organization, and leadership of the technical and/or vendor teams supporting IT. Customer Service - Works with clients and customers (that is, any individuals who use or receive the services or products that your work unit produces, including the general public, individuals who work in the agency, other agencies, or organizations outside the Government) to assess their needs, provide information or assistance, resolve their problems, or satisfy their expectations; knows about available products and services; is committed to providing quality products and services.

5 days ago

Supervisory Contract Specialist (Branch Chief) U.S. Department of Veterans Affairs

Marion, IL

$125,776–$188,573 / year

Experience with substantial coordinating and integration of a number of major work assignments, projects, or program segments of professional, scientific, technical, or administrative work including but not limited to: coordinating activities among various contracts and negotiations where timing is important, determining projects or program segments to be initiated, dropped or curtailed; restructuring or reformulating goals or objectives based on new information, changes in priorities, changes in directives or legislation that impacts VHA contracting. Waiver: When filling a specific vacant position, the senior procurement executive of the selecting agency, at his or her discretion, may waive any or all of the requirements of Paragraphs A and B above if the senior procurement executive certifies that the applicant possesses significant potential for advancement to levels of greater responsibility and authority, based on demonstrated analytical and decision making capabilities, job performance, and qualifying experience.

6 days ago

PUBLIC AFFAIRS SPECIALIST United States Air Force

Scott AFB, IL

$63,288–$82,279 / year

SPECIALIZED EXPERIENCE: I have one year of specialized experience equivalent to the GS-07 grade level in the Federal service which includes knowledge of concepts, principles, and practices of a public affairs program and written and oral communication principles, methods, and techniques to conduct and coordinate public affairs activities to develop intercommunication between the agency and a variety of publics. The primary purpose of this position is to serve as a Public Affairs Specialist, to carry out a variety of recurring precedented public affairs assignments that include elements of media operations, social media, community engagement, command information, visual information, communication planning, contingency/crisis response, special event planning, and policy review.

8 days ago

Front-End Web Developer TriWest Healthcare Alliance

Chicago, IL

Remote

Full time

Technical Skills: Knowledge of and/or experience with Adobe Creative Suite (Photoshop, Illustrator, and Acrobat) as well as Microsoft Office; Extensive knowledge of hand-coding HTML, CSS, JavaScript (including jQuery), NET (C#); Extensive knowledge of developing and testing Section 508 compliance, Knowledge of web design editing software including Microsoft Visual Studio and Adobe Dreamweaver; Proficient in PC operating systems. Consults with Communications and IT staff on architecture issues as required; consults with client departments on project issues and offers training to departments as needed to help ensure TriWest's policy on 508 compliance is enforced.

13 days ago

Temporary Manager, Personnel Background Investigator KPMG International Cooperative

Chicago, IL

$127,200–$246,900 / year

Albany, NY; Albuquerque, NM; Anchorage, AK; Ashburn, VA; Atlanta, GA; Austin, TX; Baltimore, MD; Baton Rouge, LA; Bentonville, AR; Birmingham, AL; Boise, ID; Boston, MA; Boulder, CO; Buffalo, NY; Charlotte, NC; Chicago, IL; Cincinnati, OH; Cleveland, OH; Columbus, OH; Dallas, TX; Denver, CO; Des Moines, IA; Detroit, MI; El Segundo, CA; Fort Worth, TX; Ft Lauderdale, FL; Greenville, SC; Harrisburg, PA; Hartford, CT; Honolulu, HI; Houston, TX; Indianapolis, IN; Irvine, CA; Jackson, MS; Jacksonville, FL; Kansas City, MO; Knoxville, TN; Las Vegas, NV; Lincoln, NE; Los Angeles, CA; Louisville, KY; McLean, VA; Melville, NY; Memphis, TN; Miami, FL; Milwaukee, WI; Minneapolis, MN; Montvale, NJ; Morristown, NJ; Nashville, TN; New Orleans, LA; New York, NY; Oklahoma City, OK; Omaha, NE; Orlando, FL; Philadelphia, PA; Phoenix, AZ; Pittsburgh, PA; Portland, OR; Providence, RI; Raleigh, NC; Richmond, VA; Rochester, NY; Sacramento, CA; Salt Lake City, UT; San Antonio, TX; San Diego, CA; San Francisco, CA; San Juan, PR; Santa Clara, CA; Seattle, WA; Shreveport, LA; St Louis, MO; Stamford, CT; Tallahassee, FL; Tampa, FL; Tempe, AZ; Virginia Beach, VA; Washington, DC; Winston-Salem, NC. Exceptional verbal/written communication, collaboration, presentation, and negotiation skills to lead case management and adjudication in an environment driven by customer service, high quality, and teamwork; capable of building strong professional relationships with ability to influence all levels across the organization; able to set and execute strategic initiatives for team; creative thinker with ability to identify innovative business solutions; ability to develop strategic organization and resource plans, defining next generation business and leadership needs.

15 days ago

Technical Support Specialist [Various Levels] Contingent Lufco

Belleville, IL

The specialist serves as the primary technical point of contact for command end-users, ensuring rapid incident resolution, accurate trouble ticket tracking, hardware and software lifecycle maintenance, and seamless network/workstation connectivity in accordance with Quality Assurance Surveillance Plan (QASP) service level agreements. Provide on-site technical troubleshooting and incident resolution for workstations, monitors, peripherals, printing devices (NIPR/SIPR MFDs), and local network drops.

18 days ago

Junior Compliance Officer (Operations, Junior Analyst) The MIL Corporation

Chicago, IL

$35,000–$48,000 / year

Associates degree in Business, Accounting, Finance, Information Systems, Criminal Justice, or a related field is required; Bachelors degree in Business, Accounting, Finance, Information Systems, Criminal Justice, or a related discipline is preferred. The role assists in reviewing employment eligibility documentation, conducting database research, and preparing audit-ready case filesand reports that support administrative enforcement actions and related determinations.

21 days ago

Pharmacy Claims Adjudication Specialist Onco360

Woodridge, Illinois

Skills/Knowledge Required: Pharmacy/NDC medication billing, Pharmacy claims resolution, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, NCPDP claim rejection resolution, coordination of benefits, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills. ensure prescription claims are adjudicated correctly according to the coordination of benefits, resolve any third-party rejections, obtain overrides if appropriate, and be responsible for patient outreach notification regarding any delay in medication delivery due to insurance claim rejections Pharmacy Adjudication Specialists at Onco360.

5 days ago

IT Specialist U.S. Department of Veterans Affairs

Chicago, IL

$89,508–$116,362 / year

Customer Service - Works with clients and customers (that is, any individuals who use or receive the services or products that your work unit produces, including the general public, individuals who work in the agency, other agencies, or organizations outside the Government) to assess their needs, provide information or assistance, resolve their problems, or satisfy their expectations; knows about available products and services; is committed to providing quality products and services. Specialized experience for this position is defined as: diagnosing and resolving complex hardware, software, network, application, and customer-reported incidents; installing, configuring, maintaining, and troubleshooting IT equipment and software applications; AND providing technical guidance and training to customers and lower-graded IT Specialists.

28 days ago

Product Manager – Application Security & Risk Management - Tech Delivery Bank of America

Chicago, Washington

The Product Manager – Tech Delivery will be a member of the Business Information Security Officer's (BISO) organization and work closely with Line of Business (LOB) Chief Information Officers (CIOs), Chief Technology Officers (CTOs), application development teams, architects, and technology partners. The successful candidate will partner closely with development teams, architects, security engineers, product owners, and risk partners to drive secure development practices, vulnerability remediation, and risk-based security decision making across the enterprise.

30+ days ago

Commercial Underwriter Bank of Montreal

$55,000–$120,000 / year

Builds change management plans of varying scope and type; leads or participates in a variety of change management activities including readiness assessments, planning, stakeholder management, execution, evaluation and sustainment of initiatives. Keeps current with established processes, policies, and regulations, and knowledge of products, credit policies, services, and relevant legal, regulatory, and technology requirements.

30+ days ago

Deputy Chief Administrator Will County

Joliet, IL

Job TitleDeputy Chief Administrator Job Title NoteWill County Emergency Telephone System Job SummaryUnder the general direction of the Chief Administrator, the Deputy Chief Administrator is responsible for the day-to-day management and administration of mission critical services that support the operations and service delivery by public safety answering points (PSAPs) and emergency services agencies. Will County employees enjoy a wide variety of competitive fringe benefits including: comprehensive medical coverage, dental and vision coverage, short/long term disability, sick/personal days, parental leave, holidays, defined pension plan from the Illinois Municipal Retirement Fund (regular and SLEP), deferred compensation plan, vacation, and tuition reimbursement program.

13 days ago

IT Specialist 6 month Register-Direct Hire Department of the Treasury, US

Chicago, IL

$106,437–$197,200 / year

QUALIFICATION REQUIRMENTS: To qualify for this position, you must meet the qualification requirements outlined below: MINIMUM REQUIREMENTS FOR GRADE 12 LEVEL UP (GS or Equivalent) Applicants must have Information Technology related experience demonstrating each of the following nine competencies: 1) Attention to Detail, 2) Customer Service, 3) Decision Making, 4) Information Management, 5) Interpersonal Skills, 6) Oral Communication, 7) Problem Solving, 8)Teamwork and 9) Technical Competence. To update your application, including supporting documentation: Visit USAJOBS - How to Update Application during the announcement open period, make updates or add supporting documentation, then continue through the entire application process and click Submit Application to send updates to the hiring agency.

30+ days ago

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Adjudicator Jobs in Illinois

Claims Adjudicator II UNITE HERE HEALTH

Associate Vice President, Adjudication Services CVS Health Corp

Workforce Development Specialist U.S. Department of Labor

Visual Information Specialist Department of the Treasury, US

Tax Law Specialist Department of the Treasury, US

LOGISTICS MANAGEMENT SPECIALIST United States Air Force

Manager, Personnel Background Investigations KPMG International Cooperative

Supervisory IT Specialist U.S. Department of Veterans Affairs

Supervisory Contract Specialist (Branch Chief) U.S. Department of Veterans Affairs

PUBLIC AFFAIRS SPECIALIST United States Air Force

Front-End Web Developer TriWest Healthcare Alliance

Temporary Manager, Personnel Background Investigator KPMG International Cooperative

Technical Support Specialist [Various Levels] Contingent Lufco

Junior Compliance Officer (Operations, Junior Analyst) The MIL Corporation

Pharmacy Claims Adjudication Specialist Onco360

IT Specialist U.S. Department of Veterans Affairs

Product Manager – Application Security & Risk Management - Tech Delivery Bank of America

Commercial Underwriter Bank of Montreal

Deputy Chief Administrator Will County

IT Specialist 6 month Register-Direct Hire Department of the Treasury, US

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