• Claims Quality Review…

    Cognizant (Tallahassee, FL)
    ** Claims Quality Review ** ( remote ) This is a remote position open to any qualified applicant that lives in the United States. **Summary:** Our ... quality standards, processes and procedures and policies + Ensures the claims processing reps adhere to predetermined quality assurance standards and the… more
    Cognizant (10/09/25)
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  • Claims Adjuster - Workers Compensation…

    Sedgwick (Tampa, FL)
    …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Adjuster - Workers Compensation ( Remote - Southeast State exp needed) ... best brands? + Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. + Deliver innovative customer-facing… more
    Sedgwick (10/08/25)
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  • Claims Process Executive ( remote )

    Cognizant (Tallahassee, FL)
    ** Claims Process Executive ( remote )** **JOB PURPOSE:** Claim Processors will review claim submissions, verify information, adjudicate the claim as per claim ... the business requirements. **ESSENTIAL FUNCTIONS** : + Examining and entering basic claims for appropriateness of care and completeness of information in accordance… more
    Cognizant (10/04/25)
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  • Claim Specialist - Complex Claims Unit

    The Hartford (Lake Mary, FL)
    Specialist Claims - CH07DESpecialist Claims CA - CH07DN We're determined to make a difference and are proud to be an insurance company that goes well beyond ... help shape the future. This is a visible and important role within our Complex Claims Unit (CCU) Hartford Global Specialty (HGS) Claims Division. As a Claims… more
    The Hartford (10/01/25)
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  • WC Senior Claims Specialist

    Zurich NA (Maitland, FL)
    …escalating issues as appropriate. + Establish timely reserves and perform ongoing review throughout claims cycle within authority limit by estimating and ... WC Senior Claims Specialist 126746 At Zurich North America ...available tools and resources within authority limits. + Meet quality standards by following best practices Basic Qualifications: +… more
    Zurich NA (09/16/25)
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  • Executive Director of R&D Global Quality…

    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...be reported periodically to Senior Management through the Management Review process to ensure alignment with Company policy and… more
    Otsuka America Pharmaceutical Inc. (08/14/25)
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  • Team Leader - Liability | Remote

    Sedgwick (Tallahassee, FL)
    …+ Compiles reviews and analyzes management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, ... Financial Services & Insurance Team Leader - Liability | Remote **PRIMARY PURPOSE** : To supervise the operation of...authority of the individual examiner. + Monitors third party claims ; maintains periodical review of litigated … more
    Sedgwick (10/10/25)
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  • Analyst, Quality Analytics & Performance…

    Molina Healthcare (Tampa, FL)
    …care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality department with HEDIS measure deep dive to support HEDIS audit and revenue at risk ... **Job Description** **Job Summary** The Analyst, Quality Analytics and Performance Improvement role will support...and supplemental data impact reporting. + Develop Medical Record Review project reporting to track progress and team productivity… more
    Molina Healthcare (09/18/25)
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  • Account Consultant- Remote Opportunity-…

    Sedgwick (Jacksonville, FL)
    …various specialized services such as subrogation, fraud evaluation or case management review to resolve claims . + Establishes and maintains effective ... Fortune Best Workplaces in Financial Services & Insurance Account Consultant- Remote Opportunity- Flood Experience Required **PRIMARY PURPOSE** **:** To manage claim… more
    Sedgwick (08/21/25)
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  • Sr. AI Business Analyst - Remote

    Prime Therapeutics (Tallahassee, FL)
    …requestors to resolve questions regarding requested software changes, and participate with Quality Assurance and UAT resources to review related test cases ... drives every decision we make. **Job Posting Title** Sr. AI Business Analyst - Remote **Job Description** **Are you a Business Systems Analyst with an AI background?… more
    Prime Therapeutics (10/01/25)
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