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Claims Operations Associate Jobs in DeLand, FL (NOW HIRING)

Elevance Health

Claims Auditor Lead

Lake Mary, FL · Hybrid

Claims Auditor Lead Hybrid 1: This role requires associates to be in-office1 - 2days per week ... The Claims Auditor Lead is responsible for processing high dollar claims within Service Operations.

Elevance Health

Claims Auditor Lead

Lake Mary, FL · Hybrid

Claims Auditor Lead Claims Auditor Lead Hybrid 1: This role requires associates to be in-office1 ... The Claims Auditor Lead is responsible for processing high dollar claims within Service Operations.

TopBuild Corp.

Sr. Risk Analyst- Claims

Daytona Beach, FL · Hybrid

$75K - $113K/yr

Serve as a key liaison between branch operations, TPAs, legal counsel, and insurance partners ... Associate in Risk Management (ARM) * Certified Risk Manager (CRM) * Construction Risk & Insurance ...

TopBuild Corp.

Sr. Risk Analyst- Claims

Daytona Beach, FL · On-site

$75K - $113K/yr

Serve as a key liaison between branch operations, TPAs, legal counsel, and insurance partners ... Associate in Risk Management (ARM) * Certified Risk Manager (CRM) * Construction Risk & Insurance ...

MHI

Warranty PM Associate

Lake Mary, FL · On-site

Support the administration and review of warranty claims within the warranty management database ... Support additional project management and operational activities as assigned. Requirements

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How much do claims operations associate jobs pay per hour?

As of Sep 12, 2026, the average hourly pay for claims operations associate in DeLand, FL is $18.69, according to ZipRecruiter salary data. Most workers in this role earn between $15.19 and $20.53 per hour, depending on experience, location, and employer.

What is a claims operations associate?

A Claims Operations Associate is a professional who supports the processing and administration of insurance claims. They handle tasks such as reviewing claim forms, verifying information, entering data into systems, and assisting claims adjusters or examiners with documentation and communications. Their role is crucial in ensuring that claims are processed efficiently, accurately, and in compliance with company policies and regulatory requirements. Claims Operations Associates may work for insurance companies, healthcare providers, or third-party administrators.

What skills and qualifications are needed to be a claims operations associate?

To thrive as a Claims Operations Associate, you need strong analytical abilities, attention to detail, and a solid understanding of insurance processes, often supported by a bachelor's degree or relevant experience. Familiarity with claims management systems, Microsoft Office Suite, and sometimes industry certifications like AIC (Associate in Claims) are typically required. Excellent communication, organizational skills, and problem-solving abilities help you manage complex claims and collaborate effectively with internal and external stakeholders. These competencies ensure accurate, efficient claims processing and contribute to customer satisfaction and organizational compliance.

What challenges might a claims operations associate encounter in their daily work?

As a Claims Operations Associate, you may encounter challenges such as managing a high volume of claims while ensuring accuracy and compliance with regulations. Balancing timely processing with the need to investigate discrepancies or incomplete information can be demanding. Additionally, you'll often coordinate with adjusters, customers, and other departments, so strong communication and organizational skills are essential. Staying up to date with changing policies or industry standards can also be a key part of the role.

What is the difference between Claims Operations Associate vs Claims Analyst?

AspectClaims Operations AssociateClaims Analyst
CredentialsHigh school diploma or equivalent; some roles may require relevant certificationsHigh school diploma; some roles may prefer certifications like CPCU or similar
Work EnvironmentOffice setting, handling claims processing and customer interactionsOffice or remote, analyzing claims data and making decisions
Employer & IndustryInsurance companies, third-party administratorsInsurance firms, claims departments
Search & Comparison IntentUnderstanding entry-level claims roles and responsibilitiesAnalyzing claims data and decision-making processes

The Claims Operations Associate typically handles claims processing tasks, customer service, and administrative duties within an insurance setting. In contrast, a Claims Analyst focuses more on analyzing claims data, assessing risks, and making decisions based on policy details. Both roles require knowledge of insurance policies and claims procedures, but the Claims Analyst often involves more analytical skills and data interpretation.

How much do claims operations associates make in the US?

Claims operations associates in the US typically earn an average salary ranging from $40,000 to $60,000 per year, depending on experience, location, and company size. Entry-level roles may start lower, while experienced professionals or those with specialized skills can earn higher salaries. Benefits often include health insurance, paid time off, and opportunities for advancement.

Is claims processing a stressful job?

Claims processing as a Claims Operations Associate can be stressful due to the need for accuracy, attention to detail, and meeting deadlines. The role often involves handling complex cases and working under time pressure, which can contribute to job-related stress. However, workload and stress levels vary depending on the employer and individual workload management skills.

What cities near DeLand, FL are hiring for Claims Operations Associate jobs?

Cities near DeLand, FL with the most Claims Operations Associate job openings:

Claims Operations Associate jobs near you
Infographic showing various Claims Operations Associate job openings in DeLand, FL as of June 2026, with employment types broken down into 1% As Needed, 84% Full Time, 13% Part Time, 1% Temporary, and 1% Contract. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution, with an average salary of $38,867 per year, or $18.7 per hour.

Claims Auditor Lead

Lake Mary, FL • Hybrid

Elevance Health
Health Care and Social Assistance • 10K+ employees
Learn more about Elevance Healthexternal

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 22 days ago

Elevance Health rating

7.6

Company rating: 7.6 out of 10

Based on 356 frontline employees who took The Breakroom Quiz

Job description

Claims Auditor Lead

Hybrid 1: This role requires associates to be in-office1 - 2days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unlessaccommodationis granted as required by law.

The Claims Auditor Lead is responsible for processing high dollar claims within Service Operations. Responsible for pre and post payment and adjudication audits of high dollar medical and pharmacy. Serves as the subject matter expert for the unit.

Primary duties may include, but are not limited to:

  • Responsible for all team training including but not limited to new hires, cross training, new product and system enhancements.

  • Conducts audits for new hires and/or any team member learning a new skill.

  • Reviews, interprets and maintains records of quality and productivity for entire team.

  • Coaches, mentors and develops associates to ensure processes, guidelines and tools are utilized correctly.

  • Utilizes inventory management strategies to monitor priorities and ensure timely turnaround of all claims.

  • Responsible for creating, updating and maintaining departmental policy and claims auditor procedure manuals for accuracy.

  • Independently analyzes and makes decisions on complex claim audit issues.

  • Serves as subject matter expert on policy, workflow and technical questions.

  • Interfaces with all levels of support including but not limited to production support, medical management, provider /vendor contracting and other audit teams.

  • Partners with Management on complex claims reviews and resolution.

  • Responsible for reviewing and resolving shared mailbox issues.

  • Interprets contracts, prepares monthly reports, and attends meetings as subject matter expert when requested.

  • Manages projects as assigned and may work across different platforms or lines of business.

  • Reviews and responds to external audit requests.

  • Performs audit reviews of and may adjudicate complex high dollar claims by completing an end to end audit with final approval authority.

Minimum Requirements:

Requires a HS diploma or GED and a minimum of 6 years related experience in a quality audit capacity (preferably in healthcare or insurance sector); or any combination of education and experience which would provide an equivalent background.

Preferred Requirements:

  • Proficiency in Microsoft Office Suite is highly preferred.

  • Commercial Claims experience is highly preferred

  • CI&W and WGS experience is highly preferred.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process should submit the Accessibility Accommodation Request Form and a member of the team will be in contact.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.

What Elevance Health employees say

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About Elevance Health

Sourced by ZipRecruiter

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Indianapolis, IN, US

Year founded

2004

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