- Exl Service (Jacksonville, FL)
- Overview Commercial Insurance Inspector - Independent Contractor Overview EXL Risk Control is a leading provider of risk assessments and loss control surveys to ... excellent communication skills, computer proficiency, and a commitment to meeting client quality and timeliness standards. Those with these skills as well as… more
- Molina Healthcare (St. Petersburg, FL)
- …management, Group/IPA practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, ... Management program and action plan, which includes strategies that ensure a high quality of patient care, ensuring that patients receive the most appropriate care at… more
- Sedgwick (Tallahassee, FL)
- …the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating ... completed documentation from providers to ensure accuracy, completeness, adherence to quality assurance standards. + Determine the outcome of involvement to include… more
- Sedgwick (Tampa, FL)
- …the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating ... + Performs other duties as assigned. + Supports the organization's quality program(s). **QUALIFICATIONS** **Education & Licensing** High school diploma or GED… more
- USAA (Tampa, FL)
- …are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures. **What you have:** + Bachelor's ... consulting, and/or process engineering/optimization. + Experience in successfully applying quality management, process improvement, and problem-solving tools and methodologies.… more
- Ankura (Miami, FL)
- …to provide independent professional opinions, delay and cost analysis, and practical risk mitigation strategies across some of the world's largest and most complex ... packages + Assist with data gathering activities including document review, and quality control of data entry activities + Demonstrating proper documentation of work… more
- Sedgwick (Tampa, FL)
- …the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating ... Implement and enforce data governance policies and practices to ensure data quality , security, and compliance + Performance monitoring: Develop and track key… more
- CVS Health (Tallahassee, FL)
- …work with a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and operational information ... Pharmacy Payment Compliance reporting using SQL and SAS. You will continuously improve quality controls and accuracy of reported data, looking for ways to further… more
- Humana (Tallahassee, FL)
- …higher quality and operational efficiency. + Ensure enrollment and claims processes comply with regulatory requirements and guidelines. + Partner with ... Enrollment Period (AEP). + Utilize tools such as Availity to streamline claims submission, eligibility verification, and authorization processes. + Directly lead a… more
- Siemens Energy (Orlando, FL)
- …energy industry. + Proficiency in Project Management or engineering (cost- quality -time controlling, Risk Management, Scheduling, Customer Management, Leadership, ... line with the project objectives (with regards to safety, cost, time, quality and functionality). + Ensuring project controls are established throughout the project… more