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Claim Operator Jobs in Boca Raton, FL (NOW HIRING)

Pediatric Associates

Reimbursement Specialist

Plantation, FL · On-site

$18.25 - $25.25/hr

Call and check claim status, work A/R and insurance carrier reports, and insurance denials ... Indoor Work Operating Computer Reach Outward Manual Dexterity Lift/Carry 20 lbs. or less Push/Pull ...

Wanderers Club Partners LLC

Valet Parker

Wellington, FL · On-site

$13 - $17.25/hr

Issue and collect valet claim tickets accurately. Maintain an organized and efficient traffic flow ... Follow all safety procedures and traffic regulations while operating vehicles. Communicate ...

Wellington Club

Valet Parker

Wellington, FL · On-site

$13 - $17.25/hr

... claim tickets accurately. • Maintain an organized and efficient traffic flow in valet areas. • ... while operating vehicles. • Communicate effectively with team members and management. • ...

Vesta Home

Regional Safety Manager

Pembroke Park, FL · On-site

$95K/yr

About Vesta Home Vesta Home (operating as Showroom Group) is revolutionizing the home marketing and ... Maintain complete, defensible claim files for every open case; identify unusual patterns such as ...

Vesta Home

Regional Safety Manager

Pembroke Park, FL · On-site

$95K/yr

About Vesta Home Vesta Home (operating as Showroom Group) is revolutionizing the home marketing and ... Maintain complete, defensible claim files for every open case; identify unusual patterns such as ...

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Showing results 41-60

All JobsClaim Operator JobsClaim Operator Jobs in Boca Raton, FL

Claim Operator information

See Boca Raton, FL salary details

$38.9K

$72.2K

$93.9K

How much do claim operator jobs pay per year?

As of Sep 6, 2026, the average yearly pay for claim operator in Boca Raton, FL is $72,159.00, according to ZipRecruiter salary data. Most workers in this role earn between $62,600.00 and $81,100.00 per year, depending on experience, location, and employer.

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 Boca Raton, FL?

For Claim Operator jobs in Boca Raton, FL, the most frequently searched job titles are:

What job categories do people searching Claim Operator jobs in Boca Raton, FL look for?

The top searched job categories for Claim Operator jobs in Boca Raton, FL are:

What cities near Boca Raton, FL are hiring for Claim Operator jobs?

Cities near Boca Raton, FL with the most Claim Operator job openings:

Claim Operator jobs near you

Reimbursement Specialist

Pediatric Associates

Plantation, FL • On-site

$18.25 - $25.25/hr

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

Monday - Friday, 8am-5pm EST

PRIMARY FUNCTION:  Reimbursement Specialist is responsible for analyzing the billing process to determine appropriateness in payment (reimbursement). This position manages all components of claims processing including: 1) coordination of disputed, rejected, and delayed claims, and 2) to problem solve and review returned, disputed or rejected claims from Government and other third party Payers. Additionally, this position is responsible for communicating with billers regarding coding processes to prevent future denials. 

ESSENTIAL FUNCTIONS OF THE JOB: (This list may not include all of the duties that may be assigned.) 

  1. Processes correspondence related to assigned contracted and/or non-contracted insurance carriers including self-pay accounts. 

  2. Researches denied and improperly processed claims by contacting assigned carriers to ensure proper processing of said claims. Call and check claim status, work A/R and insurance carrier reports, and insurance denials. Verifies insurance eligibility / PCP / patient benefits to reconcile denied claims. 

  3. Identifies and corrects any claim processing errors due to data entry, verification, coding and/or posting. Add or update insurance carriers into practice management system. Review the Financial Class and the Insurance Group and verify that they are in the correct financial reporting groups. 

  4. Resubmits improperly paid/denied claims to the carrier for proper payment in a timely manner. 

  5. Monitor payer payment policies (bundling process) for each carrier to ensure guidelines are followed. 

  6. Responsible for validating appeal opportunities, creating appeal letters, generating and submitting individual and/or batch appeals in a timely manner, tracking appeals and recoveries. Follow up on outstanding appeals, and work closely with the appropriate teams to validate contracts. 

  7. Communicate and escalate denial trends, short payments, or payer policies to Management. 

  8. Other various duties as assigned, including cross training in other functional areas. 

*Non patient-facing 

PERFORMANCE REQUIREMENTS: 

Adhere to all organizational information security policies and protect all sensitive information including but not limited to ePHI and PHI in accordance with organizational policy, Federal, State, and local regulations. 

TYPICAL WORKING CONDITIONS:  

Indoor Work 

Operating Computer 

Reach Outward 

Manual Dexterity 

Lift/Carry 20 lbs. or less 

Push/Pull 12 lbs. or less 

Sitting 

Other Physical Requirements 

Vision 

Sense of Sound 

Sense of Touch 

EDUCATION: High school diploma/GED or equivalent. 

LICENSURE/CERTIFICATION: None 

EXPERIENCE: Minimum of 1 year of insurance/collection experience in a medical environment preferred. 


KNOWLEDGE, SKILLS & ABILITIES:  

  • Knowledge of billing and collection policies and procedures, all types of insurance (HMO, PPO, POS, Medicaid etc.)  

  • Skill in defining problems, diagnostics of common coding errors, and impact on claims processing, collection of data, interpreting billing information.  

  • Must possess strong interpersonal skills; must be able to communicate effectively with co-workers, the Business Office Manager and must be able to work effectively as a team member within the Business Office.  

  • Ability to multi-task in a face paced environment while meeting established production and quality goals/metrics.  

  • Strong organizational skills, with ability to effectively prioritize work and daily basis and follow up on open items in a timely manner

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