An Adjudicator takes responsibility for reviewing evidence and checking all other factors to determine if the claimant is liable or not. Primary responsibilities listed on the Adjudicator Resume are – adjudicating benefit claims, working on cases assigned by the government to determine various factors such as eligibility; employment discrimination, and compliance with economic regulatory requirements; reviewing applicants case; examining background; checking all reports and facts thoroughly; preparing analysis, showing justification for the recommended course of actions; maintaining security clearance; supervising support personnel; and issuing subpoenas.
The nature of the job demands the following skills – strong abilities to comprehend all relevant information, good listening skills, the ability to identify and solve problems; staying updated with latest developments in the legal rules and regulations; and willingness to learn new concepts in law and the relevant standards. A degree in law is mandatory, however, chances are bright for those holding a master’s degree in relevant discipline.
Headline : Looking for a position as an Investigator, utilizing background and experience in the areas of investigations, operations (law), administration, technology, customer service and education to develop into one of the most effective, professional, results-orientated team members of your law firm.
Skills : Managing Time, Dispute management, Decision making, Good Communication skills.
Description :
Adjudicated monetary and separation issues after conducting investigative fact-finding.
Researched law sources and apply knowledge of state and federal statutes.
Allowed for due process and ensure interested party rebuttals.
Cross-examined claimants and employers.
Read and followed case law to apply and interpret state law.
Utilized practical knowledge of available on-line systems.
Used analysis and monitored reports to identify, validate, and document areas of individual and departmental trends.
Experience
5-7 Years
Level
Executive
Education
Bachelor Of Science
Financial Adjudicator Resume
Headline : Results-oriented, accomplished Financial Adjudicator and client support professional with an 8+ year record of achievement and demonstrated success enhancing client satisfaction while simultaneously boosting efficiencies and bottom-line results. Adept at interpreting guidelines, optimizing internal resources, forming mutually beneficial internal partnerships, and creating comprehensive patient liaison contact initiatives.
Skills : Management, Organizational skills, Claims processes, Team work.
Description :
Managed assigned cases according to changing program priorities, Intelligence Community Directive (ICD) 704 Adjudicative Guidelines and established deadlines for an Intelligence Community customer.
Scheduled and conducted personal interviews with case Subjects to clarify and elicit relevant information as appropriate to include scheduling conference room meetings and entering visitor requests.
Escorted uncleared visitors to and from interviews.
Maintained and ensured accuracy of security files.
Reviewed and tracked incoming and outgoing documentation, followed up on outstanding documentation.
Updated databases according to standard operating procedures.
Conducted analysis of statistics and financial data, reconciled personal financial data with documentation to address concerns.
Experience
5-7 Years
Level
Executive
Education
PhD
Adjudicator III Resume
Summary : Experienced professional seeking to obtain a challenging position as an Adjudicator III which effectively utilizes 17 years experience in employment law, unemployment insurance law, investigations, HR issues and private insurance.
Skills : Decision making, Dispute management, Time management, Leadership.
Description :
Managed a high volume of unemployment insurance claims, investigations, fraud and complaints of discrimination.
Responsible for issuance / denial of $320,000 in benefits decisions weekly.
Interviewed claimants and employers, informing them of their legal rights.
Securied and analyzed evidence, witness statements and policy or law violated.
Issued written determinations based on all facts received, policy and law.
Responsible for appropriate interpretation of Nevada law, rules and regulations of Unemployment Insurance.
Examined, evaluated, administered & resolved issues related to Unemployment Insurance Compensation benefits.
Experience
10+ Years
Level
Senior
Education
BA
Adjudicator II Resume
Summary : Attorney with in-house counsel, employment law, veterans benefits claims, and e-discovery experience. Also desires to attain more specialized knowledge in the previously mentioned areas, as well as government affairs, entertainment and art law, crisis management and political consulting.
Skills : Strong Writing ability, Researcher, Analyst, Law management.
Description :
Adjudicated cases for the Department of Justice EOUSA department.
Administered all administrative security services requirements associated with the receipt, distribution, inventory, reproduction, and disposition of classified material.
Prepared, submitted, and monitored requests and approvals for Department of Justice Clearances.
Assisted in monitoring and updating all security databases I .e.JPAS, PIPS, EQIP, JSTARS, RIBITS for tracking personnel security clearances, and accesses.
Administered sponsorships for the HSPD-12 program.
Provided expert analysis of investigative reports, credit data, personnel files, personnel security interviews to properly adjudicate cases within EOUSA.
Applied all required procedures, policies, and regulations for adjudications/investigations to effectively and efficiently documenting security adjudications utilizing adjudicative guidelines.
Experience
7-10 Years
Level
Management
Education
Law
Adjudicator I Resume
Summary : Highly qualified Adjudicator with experience in the industry. Enjoy creative problem solving and getting exposure on multiple projects, and would excel in the collaborative environment on which your company prides itself.
Skills : Organizational skills, Dispute management, Team work, Good Communication skills.
Description :
Reviewed applications for completeness of persons who seek a HAZMAT endorsement, access to U.S.
Conducted extensive legal research on criminal records.
Reviewed the FBI's IAFIS (Integrated Automated Fingerprint Identification System) criminal records on the applicant to ensure that there are no permanent or interim disqualifying offenses.
Reviewed the FBI's NCIC (National Crime Information Center) criminal records to identify protection orders, open warrants, parole and probation violations on applicant.
Checked and verified individuals' passports through PIERS (Passport Information Electronic Retrieval System) a Department of State system.
Checked ONRA (Office of National Risk Assessment) hits on the applicant to ensure he/she is not a national security threat.
Verified alien's immigrations status by running a SAVE (Systemic Alien Verification and Entitlements) through USCIS.
Experience
7-10 Years
Level
Consultant
Education
BA
L&I Medical Treatment Adjudicator Resume
Headline : Highly qualified Adjudicator with experience in the industry. Detail-oriented attorney with substantial investigatory experience and superior research and writing skills.
Adjudicated investigative reports and case files involving derogatory, conflicting data from personnel security, counterintelligence, or criminal investigations.
Prepared letters of intent to deny/revoke security clearances.
Provided follow-up determinations and guidance to security interviewers relevant eligibility decisions on personnel for specific MOS Enlistment Option Programs under the U.S.
Worked for or on behalf of the federal government, eligibility to occupy national security positions, eligibility to access classified National Security Information (NSI), and access Sensitive Compartmentalized Information (SCI).
Perform to established standards and work in a fast-paced environment.
Provided extensive investigation, project and case management and decision making for government based unemployment compensation working with both employers and employees.
Determined benefit eligibility and resolved fraud issues with individual claims.
Experience
5-7 Years
Level
Executive
Education
BA
Disability Claims Adjudicator Resume
Summary : Asa Disability Claims Adjudicator supported administration where skills indiscretion, record keeping, data entry, mass communication, accounts receivable, and/or accounts payable will contribute to efficient operation. Managed high volume workload in a fast-paced environment.
Skills : Management, Research, Time management, Leadership.
Description :
Collected and completed background information for employees of the State and Tribal Laws.
Implemented policies for background investigations for charter schools, public schools, health centers, and community employment.
Created system to carry out the policies and for tracking and storage.
Used extensive project management, legal stature interpretation, and conflict resolution.
Managed high volume workload in a fast-paced environment.
Provided a case summary, including research of disqualifying criminal offenses, immigration issues, and any identity discrepancies.
Adjudicated claims for disability in the state of Alabama, Utilized, comprehended, and interpreted elements of the Social Security Act.
Experience
10+ Years
Level
Senior
Education
Diploma In Law
Personal Security Specialist Adjudicator Resume
Summary : To evaluate the effectiveness of programs and operations, as well as, the productivity and efficiency of management. Looking for Personal Security Specialist Adjudicator position and further enhance proper skills.
Served as Security Subject Matter Expert (SME) to senior leadership, Office of Chief Security Officer (OCSO), Personnel Security Division (PSD), state, local, tribal and private sector regarding personnel, administrative, physical and industrial security matters.
Independently reviewed complex background investigations and make decisions regarding pre-employment vetting, suitability for federal employment.
Prepared well written correspondence to include, but not limited to, letters of interrogatories, case summaries, eligibility notifications, and notices of adverse actions conforms to legal, regulatory, and procedural requirements.
Contacted or issued written correspondence with individuals, outside entities or other government agencies for additional information.
Reviewed correspondence from other staff members to ensure professional quality products.
Worked with advanced security systems which includes Integrated Security Management System (ISMS), Joint Personnel Adjudication System (JPAS), Clearance Verification System (CVS) or Electronic Questionnaires for Investigations Processing (eQip), Treasury Enforcement Communications System (TECS), Person Centric Query Service (PCQS/CIS) and Scattered Castles (SCATS).
Set the overall objectives and goals of the CISA Adjudications Branch and Personnel Security Division,as well as, determining the resources, planning, direction and execution of all programs under the purview of that Branch.
Experience
10+ Years
Level
Senior
Education
Bachelor Of Arts
Lead Adjudicator Resume
Summary : Self-supervised, self-motivated, and detail oriented. Excellent analytical, organizational, and communication skills. Ability to prioritize and complete multiple tasks. Experienced in dispute resolution.
Skills : Dispute management, Team work, Good Communication skills, Management.
Description :
Processed and adjudicated separations between employee and employers based on policies of the State of Ohio.
Prepared and gave information for audits.
Updated and corrected hierarchy information.
Responsible for reviewing pharmacy charges and printing monthly statements.
Updated daily census on all facilities for any patients leaving or returning via Docutrack received from the business office.
Filled perscriptions in the pharmacy to be delivered to the facility.
Worked credits and entering them into the system.
Experience
10+ Years
Level
Senior
Education
Bachelor Of Arts
Adjudicator Resume
Summary : Accomplished, achievement-driven and results oriented professional with over ten years of experience in fundraising, event management, volunteer coordination, and procurement marketing. Dedication reflects both in accomplishments in paid positions as well as in many hours devoted to volunteering. Highly accomplished in organizational abilities, people skills, and business intelligence with computer proficiency and knowledge of database programs.
Skills : Claims Payment, Medical Terminology, COB Claims Payment, Time management.
Description :
Provided leadership over the adjudications program, including management of a headquarters staff, and is accountable for personnel security operations at locations in the National Capital Region.
Reviewed unemployment cases and examined background information and kept secure, detailed and organized records for each claimant.
Authorized the payment of valid claims and called claimants to inquire about claim forms incorrectly filled out.
Explained rulings to claimants and how they could appeal decisions.
Audited previous claims to ensure accuracy, assessed fines if fraudulent information was found.
Adjudicated all claims before medication left the building for delivery.
Faxed Insurance the proper information needed for audits.
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