32 Results for

Adjudicator Jobs in the United States

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Jobs

Vienna, VA28 days ago

$143,913–$187,093 Per Year

You 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.

Peoria, IL30+ days ago

Utilizing 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.

Oklahoma City, OK30+ days ago

Ability 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.

New!

Salem, OR2 days ago

$4,954–$7,592

2) Three years of responsible pertinent experience which provided a knowledge of human anatomy and physiology, physical and mental impairments, how the impairments affect work performance and the treatment, prognosis and duration for physical and mental impairments (e.g., Military Corpsman, Nurse, Psychiatric Aide, Medical Assistant, Bodily Injury Claims Adjudication, Industrial Therapist, etc.). Three years of experience compiling and analyzing facts to determine eligibility requirements in compliance with program guidelines and regulations, two of the three years must include evaluating applicants for Social Security Disability Insurance and Supplemental Security Income program benefits; AND.

New!

Tumwater, WA5 days ago

$64,776–$87,048 Per Year

The 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.

McLean, VA30+ days ago

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. 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.

McLean, VA30+ days ago

Responsibilities: 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.

McLean, VA30+ days ago

Responsibilities: 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.

Redlands, CA24 days ago

Able 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.

Birmingham, AL30+ days ago

Responsibilities 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.

Tumwater, WA30+ days ago

$54,504–$73,284 Per Year

Required: 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.

New!

East Brunswick, NJ4 days ago

$23–$26 Per Hour

Norwescap 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.

Washington, District of Columbia10 days ago

As 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.

Oak Brook, IL30+ days ago

Remote

$23.79–$29.13 Per 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. 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.

McLean, VA30+ days ago

Clearance: 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.

McLean, VA25 days ago

Personnel 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.

McLean, VA17 days ago

Clearance: 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.

Oak Brook, IL30+ days ago

Remote

$20.36–$24.97 Per 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.

Atlanta, GA30+ days ago

Actions 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.

Land O Lakes, FL27 days ago

Part-time

NOTE: 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.

New!

Georgia5 days ago

Job 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.

Springfield, VA12 days ago

$27–$28 Per Hour

Physical 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).

Springfield, Missouri13 days ago

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).

Remote13 days ago

Remote

This 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.

Lexington, KY30+ days ago

Remote

At 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.

Adairville, KY26 days ago

Adairville, KY30+ days ago

12 days ago

$18.27–$25.72 Per Hour

This 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.

New!

Cincinnati, OHToday

Performs 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.

Land O Lakes, Florida30+ days ago

Arlington, VA27 days ago

$176,399–$209,600 Per Year

The 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.

New!

4 days ago

Event 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.

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Adjudicator Jobs in the United States

SEVP Appeals Adjudicator U.S. Department of Homeland Security

Warranty Claims Adjudicator Infosys Ltd

Adjudicator State of Oklahoma

Disability Adjudicator (Disability Analyst 2) State of Oregon

L&I Workers' Compensation Adjudicator 4/Trainer State of Washington

Personnel Security Analyst / Adjudicator - Senior w/ TS/SCI with FSP Xcelerate Solutions LLC

Personnel Security Analyst / Adjudicator - Junior w/ TS/SCI with FSP Xcelerate Solutions LLC

Personnel Security Analyst / Adjudicator - Mid w/ TS/SCI with FSP Xcelerate Solutions LLC

Claims Adjudicator Sr Loma Linda University Medical Center

Senior Claims Adjudicator NAPHCARE, INC.

L&I Workers' Compensation Adjudicator 2/ Claim Manager Apprentice State of Washington

Senior Adjudicator Norwescap

Senior Security Adjudicator One Federal Solution

Claims Adjudicator III UNITE HERE HEALTH

Personnel Security Analyst / Adjudicator – Mid w/ TS/SCI with FSP VMD Corp

Personnel Security Analyst / Adjudicator – Senior w/ TS/SCI with FSP VMD Corp

Personnel Security Analyst / Adjudicator – Junior with FSP VMD Corp

Claims Adjudicator II UNITE HERE HEALTH

Adjudicator 2 - Settlement Division -LEP011 - State Board of Workers'' Compensation State of Georgia

Accounts Payable Claims Adjudicator Gulfside Healthcare Services, Inc.

Background Adjudicator Wayne Farms

Personnel Security Specialist I Adjudicator Amentum Services Inc

Personnel Security Specialist I Adjudicator Amentum

Claims Adjudicator WellSense Health Plan

Adjudicator, Provider Claims - Remote Must reside in KY Molina Healthcare Inc

Adjudicator, Provider Claims (must reside in Kentucky) Molina Healthcare Inc

Adjudicator, Provider Claims-KY-On the phone-closing shift Molina Healthcare Inc

Claims Adjudicator Well Sense Health Plan Inc

Claims Adjudicator WELL SENSE HEALTH PLAN

Accounts Payable Claims Adjudicator Gulfside Career

Administrative Law Judge U.S. Department of Justice

Event Staff, Heritage Festivals - Seasonal WorldStrides

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