Perform basic claim file review and investigations * Demonstrate effective communication skills (verbal and written) * Demonstrate customer service skills by building and maintaining relationships ...
Perform basic claim file review and investigations * Demonstrate effective communication skills (verbal and written) * Demonstrate customer service skills by building and maintaining relationships ...
Perform periodic claim file reviews and audits to ensure data integrity, regulatory compliance, and adherence to company claims procedures. * Support company safety and risk management initiatives ...
New
Perform periodic claim file reviews and audits to ensure data integrity, regulatory compliance, and adherence to company claims procedures. * Support company safety and risk management initiatives ...
New
Operations Intake/Triage Associate
Lake Worth, FL · On-site
$45K - $52K/yr
... claim file setup and organization Triage Support * Route claims based on predefined rules and ... Escalate unclear or complex cases for review Quality & Compliance * Ensure data accuracy and ...
Operations Intake/Triage Associate
Lake Worth, FL · On-site
$45K - $52K/yr
... claim file setup and organization Triage Support * Route claims based on predefined rules and ... Escalate unclear or complex cases for review Quality & Compliance * Ensure data accuracy and ...
Operations Intake/Triage Associate
Lake Worth, FL · On-site
$45K - $52K/yr
... claim file setup and organization Triage Support * Route claims based on predefined rules and ... Escalate unclear or complex cases for review Quality & Compliance * Ensure data accuracy and ...
Operations Intake/Triage Associate
Lake Worth, FL · On-site
$45K - $52K/yr
... claim file setup and organization Triage Support * Route claims based on predefined rules and ... Escalate unclear or complex cases for review Quality & Compliance * Ensure data accuracy and ...
Reviewing assigned claims * Contacting the insured and other affected parties, * Setting expectations for the remainder of the claim process, and thoroughly documenting activities in the claim file.
Reviewing assigned claims * Contacting the insured and other affected parties, * Setting expectations for the remainder of the claim process, and thoroughly documenting activities in the claim file.
Reviewing assigned claims * Contacting the insured and other affected parties, * Setting expectations for the remainder of the claim process, and thoroughly documenting activities in the claim file.
Reviewing assigned claims * Contacting the insured and other affected parties, * Setting expectations for the remainder of the claim process, and thoroughly documenting activities in the claim file.
Reviewing assigned claims Contacting the insured and other affected parties, Setting expectations for the remainder of the claim process, and thoroughly documenting activities in the claim file.
New
Reviewing assigned claims Contacting the insured and other affected parties, Setting expectations for the remainder of the claim process, and thoroughly documenting activities in the claim file.
New
This individual will perform exception reviews and end-to-end administration of hazard claims, including identification of damaged properties, claim filing, and ensuring hazard claims are settled ...
This individual will perform exception reviews and end-to-end administration of hazard claims, including identification of damaged properties, claim filing, and ensuring hazard claims are settled ...
Claim Assistant
Maitland, FL · On-site
$18 - $19/hr
This position plays a key part in keeping claim files accurate, organized, and moving efficiently through the review process. The ideal candidate is detailoriented, dependable, and comfortable ...
Claim Assistant
Maitland, FL · On-site
$18 - $19/hr
This position plays a key part in keeping claim files accurate, organized, and moving efficiently through the review process. The ideal candidate is detailoriented, dependable, and comfortable ...
Claim Assistant
Maitland, FL · On-site
$18 - $19/hr
This position plays a key part in keeping claim files accurate, organized, and moving efficiently through the review process. The ideal candidate is detail-oriented, dependable, and comfortable ...
Claim Assistant
Maitland, FL · On-site
$18 - $19/hr
This position plays a key part in keeping claim files accurate, organized, and moving efficiently through the review process. The ideal candidate is detail-oriented, dependable, and comfortable ...
Claim Assistant
$18 - $19/hr
This position plays a key part in keeping claim files accurate, organized, and moving efficiently through the review process. The ideal candidate is detailoriented, dependable, and comfortable ...
Claim Assistant
$18 - $19/hr
This position plays a key part in keeping claim files accurate, organized, and moving efficiently through the review process. The ideal candidate is detailoriented, dependable, and comfortable ...
Claim Representative, Medical Only
Maitland, FL · On-site
$23 - $25/hr
... files in accordance with corporate claim standards and applicable laws • Establish reserves and provide reserve recommendations within authorized levels under direct supervision • Review and ...
Claim Representative, Medical Only
Maitland, FL · On-site
$23 - $25/hr
... files in accordance with corporate claim standards and applicable laws • Establish reserves and provide reserve recommendations within authorized levels under direct supervision • Review and ...
Claim Representative, Medical Only
Maitland, FL · On-site
$23 - $25/hr
... files in accordance with corporate claim standards and applicable laws Establish reserves and provide reserve recommendations within authorized levels under direct supervision Review and approve ...
Claim Representative, Medical Only
Maitland, FL · On-site
$23 - $25/hr
... files in accordance with corporate claim standards and applicable laws Establish reserves and provide reserve recommendations within authorized levels under direct supervision Review and approve ...
SIU Commercial Lines Specialist - Full Time/Remote
Lake Mary, FL · On-site
$38 - $44/hr
Essential Duties and Responsibilities: · Conduct in depth claim file reviews to determine if suspect activity on claim exists, make determination if claim needs to be reported to applicable state ...
Quick apply
SIU Commercial Lines Specialist - Full Time/Remote
Lake Mary, FL · On-site
$38 - $44/hr
Essential Duties and Responsibilities: · Conduct in depth claim file reviews to determine if suspect activity on claim exists, make determination if claim needs to be reported to applicable state ...
Desk Adjuster
Lake Mary, FL · On-site
Handle the adjusting of the entire claim, including collecting and reviewing all loss related facts ... Establish ultimate reserves (anticipated cost to bring file to closure based on known facts) as ...
Quick apply
Desk Adjuster
Lake Mary, FL · On-site
Handle the adjusting of the entire claim, including collecting and reviewing all loss related facts ... Establish ultimate reserves (anticipated cost to bring file to closure based on known facts) as ...
Construction Defect Major Case Specialist
Tampa, FL · On-site
$500K/yr
Proactively review Claim File Analysis (CFA) for adherence to quality standards and trend analysis. * Utilize diary management system to ensure that all claims are handled timely. At required time ...
Construction Defect Major Case Specialist
Tampa, FL · On-site
$500K/yr
Proactively review Claim File Analysis (CFA) for adherence to quality standards and trend analysis. * Utilize diary management system to ensure that all claims are handled timely. At required time ...
Claim Consultant Cyber & Technology
Lake Mary, FL · On-site +1
$122K - $183K/yr
Responsibilities include all aspects of claim file management from assignment to conclusion ... bill review * Understanding and analyzing potential extra-contractual liability as needed
Claim Consultant Cyber & Technology
Lake Mary, FL · On-site +1
$122K - $183K/yr
Responsibilities include all aspects of claim file management from assignment to conclusion ... bill review * Understanding and analyzing potential extra-contractual liability as needed
Construction Defect Major Case Specialist
Tampa, FL · On-site
$500K/yr
Proactively review Claim File Analysis (CFA) for adherence to quality standards and trend analysis. * Utilize diary management system to ensure that all claims are handled timely. At required time ...
Construction Defect Major Case Specialist
Tampa, FL · On-site
$500K/yr
Proactively review Claim File Analysis (CFA) for adherence to quality standards and trend analysis. * Utilize diary management system to ensure that all claims are handled timely. At required time ...
Claim Consultant Cyber & Technology
Lake Mary, FL · On-site +1
$122K - $183K/yr
Responsibilities include all aspects of claim file management from assignment to conclusion ... bill review * Understanding and analyzing potential extra-contractual liability as needed
Claim Consultant Cyber & Technology
Lake Mary, FL · On-site +1
$122K - $183K/yr
Responsibilities include all aspects of claim file management from assignment to conclusion ... bill review * Understanding and analyzing potential extra-contractual liability as needed
Construction Defect Major Case Specialist
Tampa, FL · On-site
$500K/yr
Proactively review Claim File Analysis (CFA) for adherence to quality standards and trend analysis. * Utilize diary management system to ensure that all claims are handled timely. At required time ...
Construction Defect Major Case Specialist
Tampa, FL · On-site
$500K/yr
Proactively review Claim File Analysis (CFA) for adherence to quality standards and trend analysis. * Utilize diary management system to ensure that all claims are handled timely. At required time ...
Claim File Reviewer information
See Florida salary details
$10.73 - $11.80
4% of jobs
$11.80 - $12.86
9% of jobs
$13.55 is the 25th percentile. Wages below this are outliers.
$12.86 - $13.92
18% of jobs
$13.92 - $14.99
16% of jobs
The median wage is $15.19 / hr.
$14.99 - $16.05
17% of jobs
$17.03 is the 75th percentile. Wages above this are outliers.
$16.05 - $17.12
13% of jobs
$17.12 - $18.18
10% of jobs
$18.18 - $19.25
5% of jobs
$19.25 - $20.31
3% of jobs
$20.31 - $21.37
2% of jobs
$21.37 - $22.44
3% of jobs
$10
$16
$22
How much do claim file reviewer jobs pay per hour?
What is a claim file reviewer?
What are some common challenges claim file reviewers face when evaluating complex insurance claims?
What are the key skills and qualifications needed to thrive as a claim file reviewer, and why are they important?
What is the difference between Claim File Reviewer vs Claims Adjuster?
| Aspect | Claim File Reviewer | Claims Adjuster |
|---|---|---|
| Required Credentials | High school diploma or equivalent; some roles may require insurance certifications | High school diploma; insurance licenses or certifications often preferred |
| Work Environment | Office setting, reviewing claim files and documentation | Office or field, investigating claims and interacting with claimants |
| Industry Usage | Insurance companies, third-party administrators | Insurance companies, independent adjusting firms |
| Search & Comparison Intent | Understanding role differences, job requirements, and career paths | Comparing responsibilities, credentials, and work scope |
The Claim File Reviewer primarily focuses on reviewing and verifying claim documentation within an office environment, often requiring minimal certifications. In contrast, Claims Adjusters investigate claims, sometimes in the field, and may hold insurance licenses. Both roles are integral to the insurance industry but differ in scope, responsibilities, and required credentials.
What are popular job titles related to Claim File Reviewer jobs in Florida?
For Claim File Reviewer jobs in Florida, the most frequently searched job titles are:
What job categories do people searching Claim File Reviewer jobs in Florida look for?
The top searched job categories for Claim File Reviewer jobs in Florida are:

Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 7 days ago
AAA The Auto Club Group rating
7.4
Based on 283 frontline employees who took The Breakroom Quiz
236th of 315 rated insurance
Job description
Job Type:
Full timeExempt/Non Exempt:
Job Description:
Location Details:
Remote - USA
Position Schedule / Shift:
Monday - Friday: 9:00 AM EST - 6:00 PM EST
Position Summary:
As a Desk Homeowners Claim Representative II, you'll be at the forefront of helping customers recover from property losses, providing support when they need it most. In this fast-paced and rewarding role, you'll manage claims from start to finish by investigating losses, reviewing coverage, evaluating damages, negotiating settlements, and collaborating with internal partners to ensure timely and fair outcomes. If you thrive in a role that combines critical thinking, customer advocacy, and decision-making authority, this is an opportunity to make a real difference every day.
Preferred applicants should reside within a 50-mile radius of Tampa, Florida.
Key Responsibilities:
Review assigned claims.
Contact the insured and other affected parties.
Set expectations for the remainder of the claim and initiate documentation in the claim handling system.
Complete coverage analysis including a review of policy coverages and provisions, and the applicability to the reported loss.
Ensure all possible policyholder benefits are identified.
Create additional sub-claims if needed or refer complex claims to management or the appropriate claim handler.
Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should be paid the applicable limits or exclusions and possible recovery potential.
Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim.
Evaluate the financial value of the loss.
Approve payments for the appropriate parties accordingly.
Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit).
Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system.
Utilize strong negotiating skills.
Employees assigned to Homeowner/CAT claim unit will handle claims generally valued between $5,000 and $25,000 (for the inside desk role) and up to $100,000 (for field role).
Investigate claims requiring coverage analysis.
Review estimates for accuracy.
May monitor contractor repair status and updates.
Qualifications:
Required
Education:
Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience
In states where an Adjuster's license is required, the candidate must be eligible to acquire a State Adjuster's license within 90 days of hire and maintain as specified for appropriate states.
A valid driver's license is required if the primary responsibilities of the role involve conducting in-person inspections or frequent in-person meetings with members.
Experience:
One year of experience with:
Negotiating claim settlements
Securing and evaluating evidence
Preparing manual and electronic estimates
Subrogation claims
Resolving coverage questions
Taking statements
Establishing clear evaluation and resolution plans for claims
Knowledge and Skills:
Knowledge of:
Essential Insurance Act (Michigan)
Fair Trade Practices Act as it relates to claims
Subrogation procedures and processes
Intercompany arbitration
Building construction and repair techniques
Ability to:
Handle claims to the line Claim Handling Standards
Follow and apply ACG Claim policies, procedures and guidelines
Work within assigned ACG Claim systems including basic PC software
Perform basic claim file review and investigations
Demonstrate effective communication skills (verbal and written)
Demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns
Analyze and solve problems while demonstrating sound decision making skills
Prioritize claim related functions
Process time sensitive data and information from multiple sources
Manage time, organize and plan workload and responsibilities
Safely operate a motor vehicle to visit repair facilities, homes (for inspections), patients, etc.
Research, analyze, and interpret subrogation laws in various states
Travel outside of assigned territory which may involve overnight stay
Relocate, work evenings or weekends
Strong negotiating skills
Preferred
Education:
Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience
Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, associate in management or equivalent
Xactimate experience
Excellent customer service skills
Excellent communication skills both oral and written
Call center or queue calling experience preferred, but not required
Knowledge of full cycle claim handling
Active Florida adjuster's license
Work Environment:
This position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy.
Compensation & Benefits Overview:
ACG complies with all applicable state and local laws regarding required benefits (including PTO, paid sick leave, etc.).
Compensation
A Desk Homeowners Claim Representative II earns a competitive annual salary of $60,000.00 - $75,000.00 along with the opportunity for an annual company bonus incentive.
Benefits
At ACG, we offer a comprehensive and flexible benefits package designed to support your health, financial well-being, and professional growth.
Health & Wellness
Medical plans with multiple coverage options, including HSA eligibility.
Prescription drug coverage.
Dental and vision benefits.
Employee Assistance Program (confidential support services).
Financial Protection & Insurance
Company-paid basic life insurance.
Optional supplemental life insurance and dependent coverage.
Short-term and long-term disability coverage.
Critical illness, accident, and pet insurance options.
Retirement & Savings
401(k) plan to support long-term financial goals. 3% automatic deferral upon eligibility; may contribute 1% to 50% of eligible earnings, either pre or post tax. Company match of 50% paid on employee contributions up to 6% of pay, payable to employees following the end of the year; immediate vesting. Additional company contribution of 4% of pay each pay day into your account; 100% vested after three (3) years of service.
Health Savings Account (HSA) and Flexible Spending Accounts (FSA) options.
Time Off & Leave
Paid Time Off (PTO): Accrual-based, increases with tenure, eligible at 90 days of employment. Full-time new employees will receive up to 12 PTO days annually; accrual based on start date and may include additional PTO based on role and/or state & local requirements. Part-time employee PTO hours are calculated based upon the standard weekly hours the employee is scheduled to work and will accrue at a minimum of 3 hours per month.
Paid Holidays: Full-time employees are eligible for 10 company-paid holidays annually, in addition to 1 mental health day, 2 floating holidays and 1 volunteer day. Holidays vary by business unit schedules. Part-time employees are eligible for 8 company-paid holidays annually, in addition to 1 mental health day and 2 floating holidays. Holidays vary by business unit schedules.
Paid leave programs, including parental, bereavement, jury duty, and military leave.
Career Growth & Education
Tuition assistance (up to $5,250 annually; 80% covered by ACG).
Professional certification support with 100% reimbursement for eligible programs.
Opportunities for career development and advancement.
Additional Perks
Complimentary AAA membership with roadside assistance and travel discounts.
Adoption assistance program.
Job Posting Period:
This position is expected to remain posted through September 30, 2026; however, it may close at any time once a qualified candidate pool is identified.
Who We Are
Become a part of something bigger.
The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America.
By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance.
And when you join our team, one of the first things you'll notice is that same, whole-hearted, enthusiastic advocacy for each other.
We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger.
To learn more about AAA The Auto Club Group visit www.aaa.com
Important Note:
ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals. ACG utilizes a geographic pay differential as part of the base salary compensation program. Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates. Salary at time of offer is determined based on these and other factors as associated with the job and job level.
The above statements describe the principal and essential functions, but not all functions that may be inherent in the job. This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements.
The Auto Club Group, and all its affiliated companies, is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status.
Regular and reliable attendance is essential for the function of this job.
AAA The Auto Club Group is committed to providing a safe workplace. Every applicant offered employment within The Auto Club Group will be required to consent to a background and drug screen based on the requirements of the position.
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About American Automobile Association
Sourced by ZipRecruiter
The American Automobile Association (AAA), headquartered in Heathrow, Florida, USA, is a reputable force in the automotive and insurance industry. Originating in 1902, it began as a coalition of motor clubs with the common goal of providing better roads and travel conditions for motorists. Today, AAA is a comprehensive, multifaceted organization that offers a range of services, including roadside assistance, auto repair services, travel agency services, and diverse insurance products - Auto, Home, Life and more. A significant principle for AAA is to continuously deliver value to their 61 million members through safety, security and peace of mind. The company's mission and core values focus on championing its members' rights and interests, advocating innovation, integrity, teamwork and respect.
Industry
Non-profits
Company size
10,000+ Employees
Headquarters location
Heathrow, FL, US
Year founded
1902