Valparaiso, IN · On-site
$23.25 - $32/hr
Adjudication Specialist Position Summary The adjudication specialist is responsible for ensuring that all client orders and customer orders are adjudicated accurately and efficiently according to a ...
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Valparaiso, IN · On-site
$23.25 - $32/hr
Adjudication Specialist Position Summary The adjudication specialist is responsible for ensuring that all client orders and customer orders are adjudicated accurately and efficiently according to a ...
Rockville, MD · On-site
The Adjudication Specialist will collect information from individuals, and various local, state, and federal databases. Manage and prepare requests for additional information (Letters of ...
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Rockville, MD · On-site
The Adjudication Specialist will collect information from individuals, and various local, state, and federal databases. Manage and prepare requests for additional information (Letters of ...
$67K - $87K/yr
Job Summary The Senior Adjudication Lead role will guide and support the efforts of a small (6 - 8 staff) Claims Adjudication team to meet production and quality goals working closely with their ...
$67K - $87K/yr
Job Summary The Senior Adjudication Lead role will guide and support the efforts of a small (6 - 8 staff) Claims Adjudication team to meet production and quality goals working closely with their ...
Minneapolis, MN · On-site
$27.72/hr
Adjudication Administrative Assistant Category: Administration Main location: United States, Minnesota, Minneapolis Position ID:J0726-1207 Employment Type: Full Time Position Description: At the ...
New
Minneapolis, MN · On-site
$27.72/hr
Adjudication Administrative Assistant Category: Administration Main location: United States, Minnesota, Minneapolis Position ID:J0726-1207 Employment Type: Full Time Position Description: At the ...
New
Denver, CO · On-site
$18.25 - $24.75/hr
The Claims Adjudication Associate is responsible for evaluating claims submitted by policyholders or providers to determine their validity, coverage, and proper reimbursement amounts. They serve as ...
New
Denver, CO · On-site
$18.25 - $24.75/hr
The Claims Adjudication Associate is responsible for evaluating claims submitted by policyholders or providers to determine their validity, coverage, and proper reimbursement amounts. They serve as ...
New
Indianapolis, IN · On-site
$62.25 - $73/hr
Adjudication Supervisor Essential Functions: * Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee ...
Indianapolis, IN · On-site
$62.25 - $73/hr
Adjudication Supervisor Essential Functions: * Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee ...
Louisville, KY · On-site
$62.50 - $73.50/hr
Adjudication Supervisor Essential Functions: * Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee ...
Louisville, KY · On-site
$62.50 - $73.50/hr
Adjudication Supervisor Essential Functions: * Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee ...
Charlotte, NC · On-site
$17.25 - $23.50/hr
The Claims Adjudication Associate is responsible for evaluating claims submitted by policyholders or providers to determine their validity, coverage, and proper reimbursement amounts. They serve as ...
New
Charlotte, NC · On-site
$17.25 - $23.50/hr
The Claims Adjudication Associate is responsible for evaluating claims submitted by policyholders or providers to determine their validity, coverage, and proper reimbursement amounts. They serve as ...
New
Louisville, KY · On-site
$59.50 - $70/hr
Adjudication Supervisor Essential Functions: * Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee ...
Louisville, KY · On-site
$59.50 - $70/hr
Adjudication Supervisor Essential Functions: * Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee ...
Woodridge, IL · On-site
$64.50 - $75.75/hr
Adjudication Supervisor Essential Functions: * Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee ...
Woodridge, IL · On-site
$64.50 - $75.75/hr
Adjudication Supervisor Essential Functions: * Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee ...
New Hyde Park, NY · On-site
$69 - $81.25/hr
Adjudication Supervisor Essential Functions: * Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee ...
New Hyde Park, NY · On-site
$69 - $81.25/hr
Adjudication Supervisor Essential Functions: * Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee ...
Waltham, MA · On-site
$70.75 - $83.25/hr
Adjudication Supervisor Essential Functions: * Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee ...
Waltham, MA · On-site
$70.75 - $83.25/hr
Adjudication Supervisor Essential Functions: * Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee ...
Manager, Clinical Adjudication Operations Job Requisition ID: 1581 Posting Start Date: 6/2/26 At Daiichi Sankyo, we are united by a single purpose, to improve lives around the world through ...
Manager, Clinical Adjudication Operations Job Requisition ID: 1581 Posting Start Date: 6/2/26 At Daiichi Sankyo, we are united by a single purpose, to improve lives around the world through ...
$62 - $73/hr
Adjudication Supervisor Essential Functions: * Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee ...
$62 - $73/hr
Adjudication Supervisor Essential Functions: * Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee ...
Saint Louis, MO · On-site
$63.25 - $74.50/hr
Adjudication Supervisor Essential Functions: * Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee ...
Saint Louis, MO · On-site
$63.25 - $74.50/hr
Adjudication Supervisor Essential Functions: * Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee ...
Saint Louis, MO · On-site
$63.25 - $74.50/hr
Adjudication Supervisor Essential Functions: * Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee ...
Saint Louis, MO · On-site
$63.25 - $74.50/hr
Adjudication Supervisor Essential Functions: * Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee ...
New Hyde Park, NY · On-site
$69 - $81.25/hr
Adjudication Supervisor Essential Functions: * Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee ...
New Hyde Park, NY · On-site
$69 - $81.25/hr
Adjudication Supervisor Essential Functions: * Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee ...
Manhattan, NY · On-site
$19.50 - $26.50/hr
The Claims Adjudication Associate is responsible for evaluating claims submitted by policyholders or providers to determine their validity, coverage, and proper reimbursement amounts. They serve as ...
New
Manhattan, NY · On-site
$19.50 - $26.50/hr
The Claims Adjudication Associate is responsible for evaluating claims submitted by policyholders or providers to determine their validity, coverage, and proper reimbursement amounts. They serve as ...
New
Indianapolis, IN · On-site
$62.25 - $73/hr
Adjudication Supervisor Essential Functions: * Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee ...
Indianapolis, IN · On-site
$62.25 - $73/hr
Adjudication Supervisor Essential Functions: * Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee ...
Buffalo, NY · On-site
$63 - $74/hr
Adjudication Supervisor Essential Functions: * Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee ...
Buffalo, NY · On-site
$63 - $74/hr
Adjudication Supervisor Essential Functions: * Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee ...
$15.63 - $18.47
1% of jobs
$18.47 - $21.31
3% of jobs
$21.31 - $24.15
1% of jobs
$24.15 - $26.99
4% of jobs
$26.99 - $29.83
11% of jobs
$31.84 is the 25th percentile. Wages below this are outliers.
$29.83 - $32.67
6% of jobs
$32.67 - $35.51
16% of jobs
The median wage is $36.60 / hr.
$35.51 - $38.35
18% of jobs
$38.35 - $41.19
10% of jobs
$41.90 is the 75th percentile. Wages above this are outliers.
$41.19 - $44.03
16% of jobs
$44.03 - $46.88
13% of jobs
$15
$36
$46
An adjudication job involves reviewing and analyzing claims, applications, or cases to determine eligibility, compliance, or resolution based on established guidelines and policies. Adjudicators work in various fields such as insurance, legal disputes, government benefits, and background checks. Their role includes reviewing documents, verifying information, and making impartial decisions to ensure fair outcomes. Strong attention to detail, analytical skills, and knowledge of relevant regulations are essential for this role.
Professionals working in Adjudication are responsible for reviewing claims, appeals, or disputes to determine their eligibility or validity based on established guidelines and regulations. Daily tasks often include gathering and analyzing evidence, preparing detailed reports, and communicating decisions to involved parties while ensuring compliance with all applicable laws and policies. Adjudicators also collaborate frequently with internal teams such as customer service, legal, and compliance departments to ensure thorough and accurate decision-making. This role often involves managing multiple cases simultaneously, making strong organizational and time-management skills essential for success.
To excel in an Adjudication role, candidates typically need strong analytical abilities, attention to detail, and a background in legal, insurance, or compliance fields, often supported by a relevant degree or professional certification. Familiarity with case management systems, claims processing software, and regulatory databases is commonly required. Excellent problem-solving, communication, and impartial decision-making skills help professionals stand out in this position. These attributes are critical for ensuring fair, consistent, and efficient resolutions in complex claims or disputes.
$23.25 - $32/hr
Full-time
Re-posted 22 days ago
Adjudication Specialist
Position Summary
The adjudication specialist is responsible for ensuring that all client orders and customer orders are adjudicated accurately and efficiently according to a predetermined order of importance, as well as the order of importance set forth by the Pharmacist(s) on duty, or as delegated by the Lead Adjudicator. The adjudication specialist will work in all functions of the billing services department based on the needs of workflow for that day as delegated by the Lead Adjudicator or Pharmacist(s) on duty. The adjudication specialist will utilize computer hardware and software associated with In Touch Pharmaceuticals property, and any other tools needed to successfully complete their assigned tasks. The adjudication specialist will work as a part of a team to ensure that all the needs of the client and customer are met.
Job Responsibilities and Requirements
The primary purpose of the adjudication specialist is the contribution to a team effort to complete adjudication functions on all daily and monthly claims ensuring accuracy and efficiency to meet a predetermined deadline for processing. Routinely applies critical thinking skills and effectively initiates resolution to problems identified by the customer. The adjudication specialist may be required to sit for long periods of time, frequent movements of fingers and hands, and ability to maintain professionalism while handling outgoing and incoming calls from customers.
Essential Functions
The essential functions of the adjudication specialist position include: the adjudicating of all pharmacy prescription claims from clients and customers, complete daily adjudication process within the designated cut off times of each facility and adherence to company communication compliance practices.
· Customer Service
o Routinely applies telephone etiquette with peers and customers. Greeting, tone of communication and problem-solving concerns are professional.
· Daily Adjudication
o Routinely prioritizes daily adjudication based on workflow practices to meet processing deadlines.
· Monthly Adjudication
o Prioritizes designated facilities to work through monthly adjudication processes to meet end of month deadlines.
· Use of Company Resources Appropriately
o Pharmacy electronic software systems and tools
· Compliance with Company policy and procedures
o Attendance at Department meetings
o Compliance with company handbook regulations (i.e. dress code, recording your time, conduct of behavior, etc.)
o Wears ID badge and enters time clock information as required.
o Personnel Payroll System
· Compliance with Company Communication Practices
o Company electronic communication system(s)
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Pharmaceutical and medicine manufacturing
51 - 200 Employees
Valparaiso, IN, US
2004
