• Claims Manager

    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
    CHS (05/09/25)
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  • Consultant - Legal Invoice Review Quality

    Wolters Kluwer (Tallahassee, FL)
    …- 8 days a month in the office **OVERVIEW** The **Legal Invoice Review Quality Assurance Analyst ("QA Analyst"** ) for Wolters Kluwer, Fulfillment Center of ... Excellence will be responsible for performing the quality assurance testing for the Legal Bill...to exercise discretion and sound independent judgment when making audit and adjustment decisions in a law firm appeals… more
    Wolters Kluwer (08/02/25)
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  • Claims and Call Auditor (Call Center QC)

    CHS (Clearwater, FL)
    …diploma or equivalent is required + Experience in medical customer service, quality assurance , or insurance training is preferred. **Certificates, Licenses, ... **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
    CHS (06/14/25)
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  • Pharmacy Quality Assurance

    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
    Elevance Health (08/02/25)
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  • Performance Assurance Analyst

    Sedgwick (Jacksonville, FL)
    …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Performance Assurance Analyst **PRIMARY PURPOSE** **:** To monitor claims colleague ... office file audits using the Compass tool + Presents audit results to local, regional and national management as...performance management (TPM) review meetings with national TPM and Quality leaders. + Maintains technical claims and… more
    Sedgwick (07/31/25)
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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...Validation Audit setting or hospital coding or quality assurance environment preferred. + Broad knowledge… more
    Elevance Health (07/22/25)
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  • Facility Coding Inpatient DRG Quality

    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
    Banner Health (06/15/25)
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  • Auditor, Food Safety & Food Quality

    Boar's Head Brand/Frank Brunckhorst Co., LLC (Sarasota, FL)
    …+ Provide advanced super user support to functional groups (R&D, Procurement, Engineering, Quality Assurance , and Manufacturing) on QMS related issues. + Provide ... Audit Team with performing Food Safety & Product Quality audits at different venues to include but not...COAs, Allergen forms, Weight & Tare, any other product claims , etc.), as applicable. + Perform Food Safety &… more
    Boar's Head Brand/Frank Brunckhorst Co., LLC (07/01/25)
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  • Treasury - Senior Quality Analyst…

    Bank of America (Miami, FL)
    …1+ years of experience working with customers (internal/external) + Experience interpreting quality assurance standards and procedures for the organization. + ... a plus)** + 1-2 years of experience in the Banking/Financial/ Audit industry + Ability to adapt to ongoing changes...and Testing + Policies, Procedures, and Guidelines Management + Quality Assurance + Attention to Detail +… more
    Bank of America (08/02/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Tampa, FL)
    …in applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance , or clinical documentation improvement, and a ... Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes...to generate audit determinations and formulate detailed audit findings letters. + Maintains accuracy and quality more
    Elevance Health (08/01/25)
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