• 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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  • Medical Claims Adjudication - remote

    Cognizant (Tallahassee, FL)
    …1 year of Facets experience. + Experience in the analysis and processing of claims for payments, utilization review/ quality assurance procedures. + Excellent ... and able to multi-task successfully? If so, please apply today! The Claims Processor, you will ensure accurate and timely adjudication of professional and… more
    Cognizant (08/01/25)
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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 ... claim processing is required. **Travel:** None required **About the role:** As Claims Adjudication Specialist, you will be responsible for timely and accurate… more
    Cognizant (08/26/25)
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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 (Orlando, 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 (08/23/25)
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  • Quality Assurance Specialist…

    Defense Contract Management Agency (Miami, 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 an Quality Assurance Specialist (Aircraft), your resume and...at the time of application) to support your educational claims . Or, if you are using education to qualify… more
    Defense Contract Management Agency (08/20/25)
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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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