- USAA (Tampa, FL)
- …line of business operations process experience in the specific functional area (ie, Agency, Claims , Bank, etc.) or quality assurance experience in the ... us special and impactful. **The Opportunity** As a dedicated ** Quality Assurance Specialist I** , you will...of third-party workers, verifying data accuracy and compliance; conducts quality control reviews on non-complex claims processed… more
- CHS (Clearwater, FL)
- …for Claims Department strategy, planning, staffing projection, budgeting and quality assurance and improvement. * Responsibility for final hiring decisions ... **Overview** ** Claims Manager** **Servicing** **Health Insurance Policies or Benefits**...Quality to implement appropriate standards for accuracy and audit procedures intended to validate those standards are met.… more
- Healthfirst (FL)
- …Medicaid, Family Health Plus, Child Health Plus, NH Family + Experience managing a Quality Assurance or Operations Audit team. + Experience working with ... optimize operational areas. + Contribute to the overall success of the Quality Assurance service organization by identifying opportunities to continuously… more
- CHS (Clearwater, FL)
- …diploma or equivalent is required + Experience in medical customer service, quality assurance , or insurance training is strongly preferred. **Certificates, ... **Overview** ** ** ** Claims and Call Auditor (Call Center QC) -...are in excess of payment authority limits in assigned audit queues. + Listen to and view all recorded… more
- Elevance Health (Tampa, FL)
- …we are actively defining our innovative role in the industry. **Pharmacy Quality Assurance Specialist** **Location:** This role requires associates to be ... as required by law._ **Schedule: Monday - Friday; 8:00am-5:00pm** The **Pharmacy Quality Assurance Specialist** is responsible for evaluating the quality… more
- USAA (Tampa, FL)
- …methodologies, eg Six Sigma and Lean, business operations, risk management, quality assurance and control, or internal audit (in addition to the minimum ... years of experience required) may be substituted in lieu of degree. + 8 years business process execution/knowledge/experience, consulting, and/or process engineering/optimization. + 3 years of direct team lead, supervisory or management experience. +… more
- Sedgwick (Miami, FL)
- …Quality Team Lead - Workforce Absence **PRIMARY PURPOSE** **:** Supervises Performance Assurance Analysts and Total Performance Coaches on audit process and ... Provides support, feedback, and guidance concerning daily operations and audit activity to the Quality team. +...relationship; makes recommendations to operations as suggested by the audit results. + Ensures claims files are… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- …Summary** We are seeking an experienced and dynamic Executive Director of R&D Global Quality to join our team. This pivotal role will be responsible for leading a ... global team focused on R&D Quality . This global role includes direct reports in the...oversee clinical trial and submission support, lead the R&D audit program, engage with regulatory authorities, and maintain clinical… more
- 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...Validation Audit setting or hospital coding or quality assurance environment preferred. + Broad knowledge… more
- Banner Health (FL)
- …documentation completed by the health care team for the health record(s) and for quality assurance in the alignment of clinical documentation and billing codes. ... different focuses (Facility vs Profee)._ In this **Inpatient Facility-based HIMS Coding Quality Associate** position, you bring your **5 years of acute care… more