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Claim Operator Jobs in Florida (NOW HIRING)

Aldridge Pite LLP

Bankruptcy Processor

Delray Beach, FL · On-site

Purpose The Proof of Claim Processor is responsible for the accurate preparation, processing, and ... Maintains compliance with all client guidelines, Standard Operating Procedures (SOPs), operational ...

WoundGen

Revenue Cycle Manager Onsite

Miami, FL

$90K - $110K/yr

Claim status * Payment posting * Denial management * Appeals * A/R follow-up * Patient and payer ... Develop standard operating procedures and workflow processes. * Hold team members accountable for ...

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Claim Operator information

What does a claim operator do?

A Claim Operator is responsible for processing and managing insurance claims. They review claim submissions, verify documentation for accuracy, and determine the validity of claims according to company policies. Claim Operators may also communicate with clients, adjusters, and other stakeholders to gather additional information or resolve issues. Their role helps ensure that claims are handled efficiently and fairly, contributing to customer satisfaction and the integrity of the insurance process.

What are the key skills and qualifications needed to thrive as a claim operator, and why are they important?

To thrive as a Claim Operator, you need strong analytical skills, attention to detail, and a foundational understanding of insurance processes, often supported by a high school diploma or equivalent. Familiarity with claims management software, Microsoft Office Suite, and sometimes industry certifications like AIC (Associate in Claims) are typically required. Excellent communication, organization, and problem-solving abilities help in interacting with clients and resolving claims efficiently. These skills are crucial for accurately processing claims, ensuring customer satisfaction, and maintaining compliance with regulatory standards.

What are some common challenges a claim operator faces in managing insurance claims, and how can they be addressed?

Claim Operators often encounter challenges such as handling a high volume of claims, ensuring accuracy in documentation, and meeting strict deadlines. These challenges can be managed by developing strong organizational skills, utilizing claims management software efficiently, and maintaining clear communication with both clients and team members. Staying updated on regulatory changes and company policies also helps prevent errors and ensures compliance throughout the claims process.

What is the difference between Claim Operator vs Claims Adjuster?

AspectClaim OperatorClaims Adjuster
Required CredentialsHigh school diploma or equivalent; some roles may require insurance licensesHigh school diploma; licensing or certification often required
Work EnvironmentInsurance companies, claims processing centersFieldwork and office settings, inspecting damages
Employer & Industry UsageInsurance companies, third-party administratorsInsurance companies, independent adjusting firms
Common Search & ComparisonClaim OperatorClaims Adjuster

Claim Operators primarily handle the administrative processing of claims within insurance companies, focusing on data entry and documentation. Claims Adjusters, on the other hand, evaluate damages, inspect claims, and determine settlement amounts. While both roles require insurance knowledge and sometimes licensing, Claim Operators focus on processing, whereas Claims Adjusters are more involved in assessment and decision-making.

What are popular job titles related to Claim Operator jobs in Florida?

For Claim Operator jobs in Florida, the most frequently searched job titles are:

What job categories do people searching Claim Operator jobs in Florida look for?

The top searched job categories for Claim Operator jobs in Florida are:

What cities in Florida are hiring for Claim Operator jobs?

Cities in Florida with the most Claim Operator job openings:

Claim Operator jobs near you
Infographic showing various Claim Operator job openings in Florida as of August 2026, with employment types broken down into 40% Full Time, 58% Part Time, 1% Contract, and 1% Nights. Highlights an 99% Physical, and 1% Remote job distribution.

AR Revenue Cycle Manager

Dental Care Alliance

Sarasota, FL

Full-time

Re-posted 12 days ago

Job description

The Revenue Cycle Manager is responsible for the overall leadership, performance, and optimization of the insurance and patient revenue cycle processes across the organization.

This position oversees the Insurance A/R Supervisor and Insurance AR Specialist teams to ensure timely and accurate claim submission, follow-up, and reimbursement.

This role partners closely with practice managers to strengthen front-end revenue operations, including patient A/R management and over-the-counter (OTC) collection best practices to ensure financial excellence across the full patient and insurance payment lifecycle.

The Revenue Cycle Manager develops strategies to improve cash flow, reduce aged A/R, increase first-pass claim acceptance, and maintain compliance with payer and regulatory requirements.


Provide leadership for all insurance A/R, billing, and collections functions.

· Directly supervise the Insurance A/R Supervisor and Insurance A/R Specialist

· Develop and communicate clear workflows, accountability measures, and escalation procedures for unresolved claims and denials.

· Oversee all insurance accounts receivable functions to ensure timely resolution of outstanding claims and reduction of aged A/R (30/60/90+).

· Track and report cash collection, aging trends, and denial patterns.

· Analyze key performance data to identify root causes of delayed payments or rejections and lead corrective actions.

· Evaluate and refine revenue cycle workflows to improve first-pass claim acceptance and reduce rework.

· Assist with developing and maintaining standard operating procedures (SOPs) for insurance billing, follow-up, and documentation.

· Oversee onboarding and training programs for new insurance A/R staff, ensuring understanding of systems, workflows, and payer guidelines.

· Conduct regular performance reviews and provide coaching to promote skill development and accountability to A/R team members.

· Partner with operations, practice managers, front office, and clinical teams to ensure all required claim attachments are accurately captured and available in the patient’s chart prior to submission.

· Serve as the primary liaison between the RCM department and leadership, providing regular updates on department performance and process improvements.

· Partner with Practice Managers to monitor and improve patient A/R aging, ensure accurate patient balance collection, and reinforce over-the-counter (OTC) collection best practices. Supervise daily activities of the Insurance A/R Support Specialists, ensuring claims and errors are completed according to established timelines and workflows.

· Provide coaching, feedback, and ongoing training to enhance accuracy, productivity, and professional development of AR team members

.Review unresolved claims for trends, timely filing risks, or payer-specific issues, escalating to RCM leadership as appropriate.

· Ensure claims are submitted daily.

· Ensure DentalXChange errors are addressed promptly, and systemic causes are identified and resolved.

· Oversee utilization of Denticon Task Manager to ensure all tasks and claim notes are up to date and accurate.

· Ensure claims are properly submitted with required attachments through Denticon.

Performance Metrics (KPIs)

· 99% Cash Collection Rate

· Insurance AR Aging Target:

55% in 0-30 days

20% in 31-60 days

15% in 61-90 days

10% in over 90 days

· 90% First-pass acceptance rate


Apply