• Medical Claims Processor - Remote

    Cognizant (Tallahassee, FL)
    …and coverage guidelines and regulations + Experience in the analysis and processing of claims , utilization review/ quality assurance procedures + Must be able ... business operations. We are seeking **Fully Remote US Based** Claims Processors to join our growing team. The **Medical**... Processors to join our growing team. The **Medical** ** Claims Processor** is responsible for the timely and accurate… more
    Cognizant (08/26/25)
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  • Claims Processor (with Facets) - Healthcare…

    Cognizant (Tallahassee, FL)
    …+ 1 year of Facets experience. + Experience in the analysis and processing of claims for payments, utilization review/ quality assurance procedures. + Must be ... of claim processing is required. **Travel:** None required **About the role:** As Claims Processor (with Facets), you will be responsible for timely and accurate… more
    Cognizant (08/22/25)
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  • DRG Coding Auditor

    Elevance Health (Tampa, FL)
    …at least one of the following: AA/AS or minimum of 5 years of experience in claims auditing, quality assurance , or recovery auditing. + Requires at least one ... responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of.../ Clinical Validation Audit setting or hospital coding or quality assurance environment preferred. + Broad knowledge… more
    Elevance Health (08/13/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (FL)
    …in applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance , or clinical documentation improvement, and a ... and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims more
    Elevance Health (08/23/25)
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  • Medical Director Physician Advisor UM

    AdventHealth (Altamonte Springs, FL)
    …Management, the Physician Advisor is responsible for providing clinical review of utilization, claims management, and quality assurance related to inpatient ... in support of medical management programs, promoting the delivery of high quality , patient focused and cost-effective medical care. **The value you will bring… more
    AdventHealth (08/07/25)
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  • Medical Director Physician Advisor UM - Remote

    AdventHealth (Tampa, FL)
    …Management, the Physician Advisor is responsible for providing clinical review of utilization, claims management, and quality assurance related to inpatient ... in support of medical management programs, promoting the delivery of high quality , patient focused and cost-effective medical care. **The value you'll bring to… more
    AdventHealth (08/27/25)
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  • Quality Assurance Specialist

    Defense Contract Management Agency (Perry, FL)
    …announcement. Responsibilities Performs duties associated with the administration of the quality assurance provisions of contracts by designing, implementing, ... Requirements Conditions of Employment Qualifications To qualify for a Quality Assurance Specialist, your resume and supporting...at the time of application) to support your educational claims . Or, if you are using education to qualify… more
    Defense Contract Management Agency (08/21/25)
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  • Quality Assurance Specialist

    Mass Markets (FL)
    …as a trusted partner in the industry. We are seeking a detail-oriented and analytical Quality Assurance Specialist to join our team. This role is critical in ... requires a keen eye for detail, strong communication skills, and a passion for quality assurance within a BPO environment. To be considered for this role,… more
    Mass Markets (06/13/25)
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  • Experienced Call Center Quality

    Mass Markets (Macdill AFB, FL)
    …in the industry. We are hiring an Experienced QA Supervisor to lead our quality assurance efforts across multiple BPO campaigns. You'll oversee QA analysts, ... ensure compliance with client standards, and drive continuous improvement in service quality . To be considered for this role, you must complete a full application on… more
    Mass Markets (09/03/25)
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  • Call Center Quality Assurance

    TEKsystems (Deerfield Beach, FL)
    Description The Customer Service department's Quality Assurance (QA) Contractor is responsible for evaluating recorded customer service and mechanical claim ... and onscreen activities for both Customer Service and Mechanical Claims agents, 15 per day. * Assess agent performance...least 1 year of experience in a call center quality assurance setting. * Strong attention to… more
    TEKsystems (09/06/25)
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