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Claims Associate Jobs in Florida (NOW HIRING)

Miami Jewish Health

Claims Adjudicator

Miami, FL · On-site

Associates Degree Preferred Experience: * Minimum two years of experience in claims adjudication for community service programs Licenses/Certifications: * N/A Abilities Required * Knowledge of ...

Miami Jewish Health

Claims Adjudicator

Miami, FL · On-site

Associates Degree Preferred Experience: * Minimum two years of experience in claims adjudication for community service programs Licenses/Certifications: * N/A Abilities Required * Knowledge of ...

Fortegra

Claims Advisor

Jacksonville, FL · On-site

High School diploma or equivalent; associate's or bachelor's degree preferred. * Minimum 2-4 years of experience in claims processing, insurance, financial services, healthcare administration ...

Leading Edge

Healthcare Claims Supervisor

Tampa, FL · On-site

Associate degree in a field related to managing claims in the healthcare field such as business administration, accounting, finance, or a related field or equivalent experience; Bachelor level degree ...

Fortegra

Claims Advisor

Jacksonville, FL · On-site

High School diploma or equivalent; associate's or bachelor's degree preferred. * Minimum 2-4 years of experience in claims processing, insurance, financial services, healthcare administration ...

LotSolutions, Inc.

Claims Advisor

Jacksonville, FL · On-site

High School diploma or equivalent; associate's or bachelor's degree preferred. * Minimum 2-4 years of experience in claims processing, insurance, financial services, healthcare administration ...

Fortegra

Claims Advisor

Jacksonville, FL · On-site

High School diploma or equivalent; associate's or bachelor's degree preferred. * Minimum 2-4 years of experience in claims processing, insurance, financial services, healthcare administration ...

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All JobsClaims Associate JobsClaims Associate Jobs in Florida

Claims Associate information

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$10

$15

$22

How much do claims associate jobs pay per hour?

As of Sep 12, 2026, the average hourly pay for claims associate in Florida is $15.68, according to ZipRecruiter salary data. Most workers in this role earn between $12.74 and $17.26 per hour, depending on experience, location, and employer.

What does a claims associate do?

A claims associate handles claims for an insurance company. As a claims associate, your job duties may include reviewing a customer’s insurance coverage and interviewing those who have filed a claim. Your job is to ensure that a claim is processed correctly, so the customer receives the financial payout to which they are entitled. In this career, you usually work in an office, but you may need to travel to gather information about the claim. There are positions in every insurance industry so that you may work in anything from auto to life insurance. This position requires excellent research and interpersonal skills, and experience in customer service is a plus. Additional qualifications may include an associate degree.

What does a claims associate do?

A Claims Associate is responsible for reviewing, processing, and managing insurance claims submitted by policyholders. Their duties include verifying information, evaluating the validity of claims, and ensuring all necessary documentation is complete. They often communicate with customers, healthcare providers, or other parties to gather additional information and resolve any issues. Claims Associates play a crucial role in ensuring claims are processed accurately and efficiently according to company policies and regulatory guidelines.

What are the key skills and qualifications needed to thrive as a claims associate?

To thrive as a Claims Associate, you need a solid understanding of insurance policies, attention to detail, and basic analytical skills, usually supported by a high school diploma or equivalent. Familiarity with claims management systems, CRM software, and sometimes industry certifications like AIC (Associate in Claims) are commonly required. Strong communication, problem-solving, and customer service abilities set top performers apart. These skills are essential for accurately processing claims, ensuring compliance, and providing a positive experience for clients and policyholders.

What are some common challenges a claims associate may face, and how can they effectively handle them?

Claims Associates often encounter challenges such as managing a high volume of claims, navigating complex policy details, and communicating with clients who may be experiencing stress or frustration. Effectively handling these situations requires strong organizational skills, attention to detail, and clear, empathetic communication. Many Claims Associates find success by proactively prioritizing tasks, seeking guidance from senior team members when needed, and utilizing available technology to streamline documentation and follow-ups.

What is the difference between Claims Associate vs Claims Examiner?

AspectClaims AssociateClaims Examiner
Required CredentialsHigh school diploma or equivalent; some roles may prefer insurance-related certificationsHigh school diploma; insurance certifications like CPCU or similar beneficial
Work EnvironmentOffice setting, interacting with customers and internal teamsOffice setting, reviewing claims and documentation
Employer & Industry UsageInsurance companies, third-party administratorsInsurance companies, adjusting departments
Common Search & ComparisonClaims Associate vs Claims Examiner

The main difference between a Claims Associate and a Claims Examiner lies in their responsibilities. Claims Associates typically handle initial customer interactions and basic claim processing, while Claims Examiners review and assess claims in detail, often making determinations on claim validity. Both roles require similar credentials and work in comparable environments, but Claims Examiners usually have more specialized knowledge and decision-making authority.

Is being a claims associate hard?

Claims associates handle insurance claims processing, which requires attention to detail, strong communication skills, and knowledge of insurance policies. The job can be challenging due to the need for accuracy, meeting deadlines, and managing complex cases, but it is generally manageable with proper training and experience.

What is a claims associate in claims?

A claims associate is a professional who reviews, processes, and manages insurance claims to determine coverage and settlement amounts. They often work with claim documentation, use claims management software, and ensure compliance with company policies and industry regulations.
More about Claims Associate jobs

What are the most commonly searched types of Claims jobs in Florida?

The most popular types of Claims jobs in Florida are:

What are popular job titles related to Claims Associate jobs in Florida?

For Claims Associate jobs in Florida, the most frequently searched job titles are:

What job categories do people searching Claims Associate jobs in Florida look for?

The top searched job categories for Claims Associate jobs in Florida are:

What cities in Florida are hiring for Claims Associate jobs?

Cities in Florida with the most Claims Associate job openings:

Claims Associate jobs near you
Infographic showing various Claims Associate job openings in Florida as of September 2026, with employment types broken down into 1% As Needed, 70% Full Time, 25% Part Time, 1% Temporary, 2% Contract, and 1% Nights. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $32,622 per year, or $15.7 per hour.

Claims Adjudicator

Miami, FL • On-site

Miami Jewish Health
Health Care and Social Assistance • 1 - 5K employees
Learn more about Miami Jewish Healthexternal

Other

Medical, Dental, Vision, Retirement

Posted 4 days ago

Job description

Description
Miami Jewish Health is one of the largest providers of healthcare and living options for aging adults in the Southeast. Our main campus is located on 20+ acres just north of mid-town Miami, and is home to our support departments like Finance, Accounting, Human Resources, Marketing and more. Join us now to do purposeful work with our diverse and respectful team.
Job Title: Claims Adjudicator
Job Summary
This position is primarily responsible for adjudicating all medical and non-medical provider claims and submitting enrollments/disenrollment to Florida Medicaid and CMS. Position is key to PACE's revenue and expense process, procuring Medicare rate tables, processing provider claims for expenses by service line, ensuring client enrollment for accurate capitation reimbursement from Medicaid and Medicare, generating accruals for Accounting.
Essential Job Functions
  • Completes all medical claims adjudication tasks twice monthly including, tracking all claims in system, verifying referrals/authorizations, entering new providers, working expectations generating remittance notices, file transmissions and mailing checks per established department protocol
  • Obtains DDE for rates not loaded into claims system and works with IT for upload
  • Coordinates with IT to transmit batch claims to accounts payable
  • Completes all non-medical claims adjudication (Home health services, ALF, nursing Home) to include verifying claims and incidental charges, flags and researches questionable bills, prints remittance advice and check requests
  • Prepares Omnicare Pharmacy billing for site nurses to review utilization and make necessary adjustments; Prepares and obtains signatures for check requests; Submits revised excel file to IT for PDE data reporting
  • Attends weekly intake meetings to verify status on upcoming enrollments and disenrollment and follows appropriate protocol for Medicaid only and Medicare/Medicaid dual eligible participants
  • Prepares and submits monthly expense accruals to Accounting for physician, outpatient, dental, labs, x-ray, ambulance, DG clinic, hospital, nursing home, home health services, ALF's, nursing homes and pharmacy
  • Prepares and submits to accounting revenue accruals for ADI, OA3E and private pay
  • Completes responsibilities for ADI, OA3E billing, Census, Social Security checks, critical list and client eligibility per established deadlines
  • Participates in department meetings and in-services as necessary
Job Requirements
Education:
  • High school diploma or equivalent; Associates Degree Preferred
Experience:
  • Minimum two years of experience in claims adjudication for community service programs
Licenses/Certifications:
  • N/A
Abilities Required
  • Knowledge of Windows, Microsoft Outlook, Excel and Word are essential
  • Must be able to work independently and have good organizational skills
  • Must have good interpersonal communication skills
Functional Demands
Environment Work Conditions:
  • Normal working condition with adequate lighting and ventilation
Infectious Material Exposure:
  • N/A
Organizational Expectations
  • Ensures that resident's/patient's rights are adhered to
  • Demonstrates professionalism and accountability
  • Demonstrates a caring attitude consistent with Miami Jewish EmpathicareSM toward MJH residents, patients, family members, employees, and other facility guests
  • Demonstrates excellent communication skills
  • Ensures confidentiality and security of patients' medical information
  • Identifies and utilizes appropriate channels of communication
  • Able to speak, read and write English
  • Able to think and act calmly to meet unusual occurrences of the job
  • Adheres to the organization's Mission, Vision and Values
  • Participates in departmental activities, meetings and in-services and follows established guidelines
  • Maintains a safe working environment

The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed.
We believe in the power of empathy, the value of relationships and the importance of a life well-lived. Come see why Miami Jewish Health is unlike anywhere you've ever worked before. We offer competitive compensation, medical/dental/vision coverage and a 403(b)-retirement savings plan for eligible full and part-time positions, free on-campus parking, an onsite fitness center and more.
Miami Jewish Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

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