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Dental Claims Processing Jobs in Florida (NOW HIRING)

Healthcare Support Staffing

Claims Processor

Tampa, FL

$14 - $17/hr

... with dental and vision claims preferred, but not necessary Ability to utilize a claims processing system (Aldera) Ability to read an Explanation of Benefit and apply Coordination of Benefits ...

Imagenet

Claims Examiner - Remote

Tampa, FL · Remote

Process claims end-to-end * Identify and escalate complex or unusual claims for further review or ... Medical, Dental, Vision, Life, HSA, 401(k) * Paid Time Off (PTO) * 7 paid holidays * A supportive ...

Imagenet

Claims Examiner - Remote

Tampa, FL · On-site +1

Process claims end-to-end * Identify and escalate complex or unusual claims for further review or ... Medical, Dental, Vision, Life, HSA, 401(k) * Paid Time Off (PTO) * 7 paid holidays * A supportive ...

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Dental Claims Processing information

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How much do dental claims processing jobs pay per hour?

As of Sep 5, 2026, the average hourly pay for dental claims processing in Florida is $14.30, according to ZipRecruiter salary data. Most workers in this role earn between $12.93 and $15.62 per hour, depending on experience, location, and employer.

What is dental claims processing?

Dental claims processing is the procedure of reviewing, validating, and adjudicating claims submitted by dental providers to insurance companies for payment. This process involves checking the accuracy of the submitted information, verifying patient eligibility, ensuring the services are covered under the dental plan, and determining the appropriate payment or denial of the claim. Efficient claims processing helps ensure timely reimbursement for providers and accurate benefits for patients. It often requires knowledge of dental terminology, coding, insurance policies, and compliance regulations.

What are the key skills and qualifications needed to thrive in dental claims processing, and why are they important?

To excel in Dental Claims Processing, you need a solid understanding of dental terminology, insurance policies, and claims procedures, often supported by experience in dental office administration or billing. Familiarity with dental practice management software, claims management systems, and coding standards like CDT is typically required. Strong attention to detail, organizational skills, and effective communication help ensure accurate claims submission and resolution. These skills are crucial for minimizing claim denials, expediting reimbursements, and maintaining positive relationships between providers, patients, and insurers.

What are some common challenges faced in dental claims processing, and how can they be managed?

Dental claims processors often encounter challenges such as interpreting complex dental treatment codes, verifying patient eligibility, and ensuring accurate documentation for timely claim approval. Staying up-to-date with insurance policies and industry coding standards is crucial to reducing errors and claim denials. Effective communication with dental offices and insurers, attention to detail, and ongoing training can help manage these challenges and support efficient claim resolution.

What is the difference between Dental Claims Processing vs Dental Billing Specialist?

AspectDental Claims ProcessingDental Billing Specialist
CredentialsKnowledge of insurance policies, basic coding certificationsDental coding certifications, billing software proficiency
Work EnvironmentInsurance companies, dental offices, healthcare providersDental offices, billing companies, healthcare practices
Employer & Industry UsageInsurance companies, dental clinicsDental practices, billing service providers

Dental Claims Processing focuses on reviewing and submitting insurance claims for dental procedures, ensuring proper reimbursement. Dental Billing Specialists handle patient billing, coding, and payment collections. While both roles involve dental coding and insurance knowledge, Claims Processing emphasizes claim submission and follow-up, whereas Billing Specialists focus on patient invoicing and account management.

How to become a dental claims processing specialist?

To become a dental claims processing specialist, candidates typically need a high school diploma or equivalent, along with knowledge of dental insurance policies and claims procedures. Relevant skills include attention to detail, familiarity with claims processing software, and strong communication abilities. Certification programs in insurance billing or claims processing can enhance job prospects.

How to get a job as a dental claims processor?

To become a dental claims processor, candidates typically need a high school diploma or equivalent, along with knowledge of dental insurance policies and claims processing software. Relevant skills include attention to detail, communication, and familiarity with healthcare billing systems. Certification in medical billing or coding can enhance job prospects.

Is dental claims processing a stressful job?

Dental claims processing can be stressful due to the need for accuracy, attention to detail, and meeting deadlines. The role often involves handling complex insurance policies and documentation, which can contribute to work pressure, especially during high-volume periods or when resolving claim disputes.

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

The most popular types of Dental Claims Processing jobs in Florida are:

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

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

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

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

Dental Claims Processing jobs near you
Infographic showing various Dental Claims Processing job openings in Florida as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 14% Part Time, and 5% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $29,751 per year, or $14.3 per hour.

Senior Data Engineer - EDI Claims Processing

NationsBenefits, LLC

Plantation, FL • On-site

$120 - $160/hr

Other

Medical

Re-posted 13 days ago

NationsBenefits rating

6.6

Company rating: 6.6 out of 10

Based on 16 frontline employees who took The Breakroom Quiz

317th of 500 rated business services

Job description

NationsBenefits is recognized as one of the fastest-growing companies in America and a Healthcare Fintech provider of supplemental benefits, flex cards, and member engagement solutions. We partner with managed care organizations to provide innovative healthcare solutions that drive growth, improve outcomes, reduce costs, and bring value to their members.Through our comprehensive suite of innovative supplemental benefits, fintech payment platforms, and member engagement solutions, we help health plans deliver high-quality benefits to their members that address the social determinants of health and improve member health outcomes and satisfaction.Our compliance-focused infrastructure, proprietary technology systems, and premier service delivery model allow our health plan partners to deliver high-quality, value-based care to millions of members.We offer a fulfilling work environment that attracts top talent and encourages all associates to contribute to delivering premier service to internal and external customers alike. Our goal is to transform the healthcare industry for the better! We provide career advancement opportunities from within the organization across multiple locations in the US, South America, and India.

Location: Plantation, FL (On-site)

Senior Data Engineer About the Role

We are seeking an experienced Senior Data Engineer – EDI Claims Processing to join our growing Data Engineering team. This role is responsible for designing, developing, and maintaining enterprise-scale healthcare data integration solutions focused on HIPAA X12 EDI transactions, Medicaid encounters, and CMS compliance.

The ideal candidate has extensive experience building high-volume data pipelines using Databricks and SQL Server, a deep understanding of HIPAA X12 transaction standards, and hands‑on experience supporting healthcare claims processing, clearinghouse integrations, and regulatory compliance.

This is an excellent opportunity for a healthcare data engineering professional who enjoys solving complex integration challenges while delivering reliable, scalable, and compliant data solutions.

Key Responsibilities EDI Data Pipeline Engineering
  • Design, develop, and optimize enterprise-grade ingestion, parsing, validation, transformation, and delivery pipelines for HIPAA X12 transactions, including:
    • 837 (Professional, Institutional, Dental Claims)
    • 277CA (Claims Acknowledgment)
    • 999 (Implementation Acknowledgment)
    • 834 (Member Eligibility)
    • 835 (Remittance Advice)
  • Build scalable, high-performance ETL/ELT workflows using Databricks, PySpark, Delta Lake, and SQL Server.
Claims & Encounter Processing
  • Manage Medicaid encounter submissions, reconciliation, and error remediation with state Medicaid agencies.
  • Support CMS encounter processing by implementing regulatory updates, schema changes, and compliance requirements.
  • Collaborate with internal teams to ensure accurate and timely claims submissions.
Data Integration & Validation
  • Develop automated validation frameworks to ensure HIPAA compliance, SNIP validation, and business rule enforcement.
  • Maintain secure and reliable integrations with healthcare clearinghouses and trading partners.
  • Analyze and troubleshoot complex EDI processing issues across multiple systems.
Operational Excellence
  • Build monitoring, alerting, logging, and SLA reporting for production EDI workflows.
  • Continuously improve pipeline performance, scalability, and reliability.
  • Maintain technical documentation, mapping specifications, companion guide implementations, and data dictionaries.
Cross-Functional Collaboration
  • Partner with Claims Operations, Compliance, Product, IT Security, and external healthcare partners to support enterprise data integration initiatives.
  • Participate in architecture discussions and recommend best practices for healthcare data engineering.
Required Qualifications
  • Bachelor's degree in Computer Science, Information Technology, Engineering, or a related field (or equivalent experience).
  • 5–8+ years of experience as a Data Engineer, Integration Engineer, or Healthcare Data Engineer.
  • Strong expertise with HIPAA X12 EDI transaction standards, including:
    • 837 (Professional, Institutional, Dental)
    • 277CA
    • 999
    • 834
    • 835
  • Hands-on experience with Medicaid encounter processing and state Medicaid submissions.
  • Experience implementing CMS encounter regulations, schema updates, and compliance changes.
  • Strong experience with Databricks, PySpark, Delta Lake, and SQL Server.
  • Experience with healthcare claims validation platforms such as HIPAA Suite or similar EDI processing tools.
  • Strong understanding of:
    • HIPAA regulations
    • PHI security and data privacy
    • SNIP validation levels
    • EDI mapping, loops, segments, and companion guides
  • Experience integrating with healthcare clearinghouses such as Availity, Change Healthcare, or similar platforms.
  • Excellent troubleshooting, analytical, and problem-solving skills.
Preferred Qualifications
  • Experience with Azure Databricks or other cloud-based data engineering platforms.
  • Knowledge of healthcare interoperability standards such as FHIR and HL7.
  • Experience with encounter error remediation and state-specific Medicaid edit codes.
  • Background supporting Medicaid Managed Care, Medicare Advantage, or Accountable Care Organization (ACO) environments.
  • Experience building automated reconciliation, validation, and quality assurance frameworks for healthcare EDI transactions.
  • Familiarity with CI/CD pipelines and DevOps practices for data engineering.
Technical Skills
  • Databricks
  • PySpark
  • Delta Lake
  • SQL Server
  • T-SQL
  • Azure Databricks (Preferred)
  • HIPAA X12 EDI
  • Medicaid Encounters
  • CMS Encounter Processing
  • HIPAA Suite (or equivalent)
  • ETL / ELT Development
  • Data Validation & Reconciliation
  • Healthcare Claims Processing
  • Azure (Preferred)
What You'll Bring
  • Strong ownership mindset with the ability to work independently on complex technical initiatives.
  • Excellent communication and collaboration skills across technical and business teams.
  • Passion for building scalable, reliable, and compliant healthcare data solutions.
  • Commitment to delivering high-quality data engineering solutions in a fast-paced healthcare environment.
Why Join Us?

Join a collaborative team where you'll help build mission-critical healthcare data platforms that support millions of healthcare transactions. You'll work with modern data technologies, contribute to large-scale integration initiatives, and play a key role in ensuring secure, compliant, and high-quality healthcare data processing.

NationsBenefits is an Equal Opportunity Employer.

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