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Claim Processor Jobs in Miami, FL (NOW HIRING)

Lifeworks

Disability Assistant

Miami, FL · Remote

Processes incoming documents. * Reviews and analyzes FMLA and STD documents received and determines if all necessary information has been provided to proceed with claim assignment / processing.

Stellar Human Resource Services LLC

Claims

Miami, FL

The Claims Examiner is an exciting and challenging position that is the primary contact to our client throughout the claims process and help manage the investigation of their claim. The position will ...

MasTec Inc

Claims Supervisor (EX)

Coral Gables, FL · On-site

... processing of claims data. This position acts as a liaison between the claims manager, carrier ... By maintaining a thorough understanding of policy details and claim procedures, the Claims ...

Loyalty MGA

Be Seen First

Insurance Claims Adjuster

Doral, FL · On-site

$45K - $65K/yr

... claim findings to management. · Remain informed on industry trends, regulatory changes, and best practices to ensure claims are processed efficiently and accurately. · Collaborate with appraisers ...

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All JobsClaim Processor JobsClaim Processor Jobs in Miami, FL

Claim Processor information

See Miami, FL salary details

$11

$18

$25

How much do claim processor jobs pay per hour?

As of Jun 16, 2026, the average hourly pay for claim processor in Miami, FL is $18.33, according to ZipRecruiter salary data. Most workers in this role earn between $15.62 and $19.76 per hour, depending on experience, location, and employer.

What is a Claim Processor?

A Claim Processor is a professional who reviews and handles insurance claims submitted by policyholders or healthcare providers. Their main responsibilities include verifying the accuracy of claim information, ensuring all required documentation is provided, and determining whether a claim is valid under the policy terms. Claim Processors work with various types of insurance, such as health, auto, or property, and play a crucial role in ensuring timely and accurate payments. They may also communicate with customers, providers, and adjusters to resolve any discrepancies or additional information requests.

What job makes $10,000 a month without a degree?

A claim processor typically earns between $3,000 and $6,000 per month, so earning $10,000 monthly without a degree is uncommon in this role. High earnings in such jobs often depend on experience, certifications, or working in specialized or high-demand industries. Generally, roles with high income potential without a degree include sales, real estate, or certain entrepreneurial ventures, but they may require skills, networking, or licensing.

What is the role of a claims processor?

A claims processor reviews and evaluates insurance claims to determine their validity and the appropriate payout. They verify information, ensure compliance with policies, and process payments using claims management software, often working within strict deadlines. Attention to detail and knowledge of insurance policies are essential for this role.

What are some typical challenges a Claim Processor might face in their daily work?

Claim Processors often handle high volumes of paperwork and data entry, which can be challenging when ensuring accuracy and meeting tight deadlines. They may also need to interpret complex policy details or resolve discrepancies in submitted claims, requiring strong attention to detail and problem-solving skills. Additionally, Claim Processors frequently interact with policyholders, healthcare providers, or other internal teams, so effective communication and the ability to manage stressful situations professionally are important for success.

What jobs pay 2000 a day?

Claim processors typically do not earn $2,000 a day; their salaries are usually based on hourly wages or salaries. High-paying roles in finance, consulting, or specialized medical fields may reach that level, but they often require extensive experience, certifications, or advanced skills. Most jobs paying $2,000 daily are in executive, consulting, or entrepreneurial roles rather than standard claim processing positions.

What do you need to be a claims processor?

To become a claims processor, candidates typically need a high school diploma or equivalent, strong attention to detail, good organizational skills, and familiarity with claims processing software or computer systems. Some positions may require prior experience in insurance or customer service. Certifications are not usually mandatory but can enhance job prospects.

What is the difference between Claim Processor vs Claims Examiner?

AspectClaim ProcessorClaims Examiner
Required CredentialsHigh school diploma or equivalent; some roles may require insurance certificationsHigh school diploma; insurance certifications preferred
Work EnvironmentOffice settings, insurance companies, healthcare providersOffice settings, insurance companies, healthcare providers
Employer & Industry UsageInsurance companies, healthcare providers, third-party administratorsInsurance companies, third-party administrators, government agencies
Job FocusProcessing insurance claims, data entry, verifying informationReviewing claims for accuracy, compliance, and coverage decisions

While both Claim Processors and Claims Examiners work within the insurance industry handling claims, Claim Processors primarily focus on data entry and initial processing of claims. Claims Examiners review claims for accuracy and compliance, making decisions on claim approval or denial. The roles often overlap, but Claims Examiners typically require more experience or certifications and perform more in-depth analysis.

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

To thrive as a Claim Processor, you need strong attention to detail, analytical skills, and a basic understanding of insurance policies, usually supported by a high school diploma or equivalent. Familiarity with claims management software, data entry systems, and sometimes certification such as AIC (Associate in Claims) is common. Excellent organizational skills, clear communication, and the ability to handle sensitive information with discretion help individuals excel in this role. These skills ensure accurate and timely processing of claims, minimize errors, and maintain customer satisfaction and regulatory compliance.
Claim Processor jobs near you
Infographic showing various Claim Processor job openings in Miami, FL as of June 2026, with employment types broken down into 51% Full Time, 47% Part Time, and 2% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $38,127 per year, or $18.3 per hour.

Senior DME Operations & Revenue Integrity Specialist

Valgorithm

Fort Lauderdale, FL • On-site

Full-time

Posted 3 days ago

Job description

About Ease DME

Ease DME is a compliance-forward Durable Medical Equipment provider specializing in urology supplies. We are building a highly controlled, audit-ready Medicare DME operation and are seeking our first senior operations hire.

This role protects compliance, cash flow, and accreditation integrity.

Position Summary

The Senior DME Operations & Revenue Integrity Specialist owns front-end documentation compliance, insurance verification, and revenue readiness for Medicare and commercial claims. This individual ensures what ships is billable and what bills is defensible.

This is not a clerical intake role.
This is a high-accountability Medicare DME position.

Core Responsibilities

Documentation & Compliance

  • Review physician orders and supporting medical records
  • Validate medical necessity for straight, coude, and closed system catheters
  • Ensure frequency limits and diagnosis alignment meet Medicare standards
  • Maintain audit-ready patient files in NikoHealth
  • Escalate documentation risks before shipment

Insurance & Revenue Readiness

  • Verify Medicare, MA, and commercial eligibility
  • Confirm frequency limitations and coverage requirements
  • Ensure claims are documentation-complete prior to submission

Denial Prevention & Revenue Oversight

  • Analyze denial root causes
  • Improve clean-claim rate
  • Support appeals and recoupments
  • Monitor AR trends and timely filing limits

Process Development

  • Strengthen Order workflows
  • Build documentation checklists
  • Contribute to scalable team structure as volume grows
30-60-90 Day PlanFirst 30 Days – Foundation & Familiarization

Goal: Build a strong understanding of Ease DME’s billing systems, payer requirements, and compliance standards.
Milestones:

  • Complete onboarding and training on NikoHealth, payer portals, and internal workflows.
  • Review 20+ recent claims and denials to identify common issues.
  • Learn Medicare and commercial payer rules for urology supplies (catheters, frequency limits, modifiers).
  • Shadow senior billing staff to understand claim submission and follow-up cadence.
  • Achieve 90% accuracy on supervised claim submissions.
Days 31–60 – Ownership & Efficiency

Goal: Take ownership of assigned billing queues and begin improving clean-claim rates.
Milestones:

  • Independently manage daily claim submissions and follow-ups.
  • Reduce preventable denials by 15–20% through proactive documentation checks.
  • Demonstrate consistent use of NikoHealth notes and task tracking.
  • Identify recurring documentation or intake issues and communicate with the intake team.
  • Maintain ≥93% clean-claim submission rate.
Days 61–90 – Optimization & Leadership

Goal: Drive measurable improvements in revenue cycle performance and compliance.
Milestones:

  • Fully own billing and AR management for assigned payers.
  • Maintain ≥95% clean-claim submission rate and reduce aging >60 days by measurable percentage.
  • Lead at least one process improvement initiative (e.g., denial prevention workflow).
  • Support audit readiness by ensuring documentation completeness.
  • Mentor intake staff on documentation best practices impacting billing.
Why This Role Matters

This hire directly protects:

  • Medicare billing privileges
  • ACHC accreditation
  • Revenue integrity
  • Audit exposure

We are seeking someone who thinks:
“Would this survive a Medicare audit?”

Compensation

Competitive base salary with performance bonuses tied to:

  • Clean-claim rate
  • Preventable denial reduction
  • Documentation audit score

Requirements

  • 3+ years Medicare Part B DME billing experience
  • Urology supply (catheter) billing or documentation experience
  • Hands-on denial correction and appeals experience
  • Experience using NikoHealth or similar DME system
  • Strong written and verbal English communication
  • Ability to think critically under compliance pressure

Preferred:

  • Diabetes / CGM billing experience
  • ACHC or audit exposure
  • Prior workflow or team-building experience