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Health Claims Jobs in Florida (NOW HIRING)

Imagenet

Claims Examiner - Remote

Tampa, FL · On-site +1

At least 1-2 years of experience working closely with healthcare claims or in a claims processing/adjudication environment. * Experience processing Provider Dispute Resolution (PDR), appeals ...

Imagenet

Claims Examiner - Remote

Tampa, FL · Remote

At least 1-2 years of experience working closely with healthcare claims or in a claims processing/adjudication environment. * Experience processing Provider Dispute Resolution (PDR), appeals ...

The Hartford

Behavioral Health Case Manager

Sunrise, FL · Hybrid

$74K - $112K/yr

Behavioral Health Case Mgr - CT08IE We're determined to make a difference and are proud to be an ... Determines when claims contain quality of care issues and escalates these through established ...

The Hartford

Behavioral Health Case Manager

Lake Mary, FL · Hybrid

$74K - $112K/yr

Behavioral Health Case Mgr - CT08IE We're determined to make a difference and are proud to be an ... Determines when claims contain quality of care issues and escalates these through established ...

Leading Edge

Healthcare Claims Supervisor

Tampa, FL · On-site

The Claims Supervisor oversees the daily activities of the team responsible for processing the billing for healthcare services provided to patients. This role will develop and share knowledge of ...

Wellcove

Claims - Examiner, Claims

Pensacola, FL · On-site

Wellcove also addresses challenges faced in accident & health, disability, and supplemental health ... Adjudicating HP/AD claims * Handling all Outbound calls * Should be able to prioritize work and ...

Wellcove

Claims - Claims Examiner

Pensacola, FL · On-site

Wellcove also addresses challenges faced in accident & health, disability, and supplemental health ... The Long-Term Care (LTC) Claims Examiner is responsible for the accurate and timely adjudication of ...

Solis Health Plans

Claims Examiner

Doral, FL · On-site

$19 - $23/hr

Establish best practice claims paymentmethodologybased on current CMS claims paymentregulations ... Follow allappropriate Federaland State regulatory requirements and guidelines applicable to Health ...

Capital Health Plan

Claims Examiner I

Tallahassee, FL · On-site

Capital Health Plan is looking for a full-time Claims Examiner I to join our team in Tallahassee, FL. In this full-time role, you will help ensure insurance claims are reviewed, evaluated, and ...

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All JobsHealth Claims JobsHealth Claims Jobs in Florida

Health Claims information

See Florida salary details

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How much do health claims jobs pay per hour?

As of Sep 6, 2026, the average hourly pay for health claims in Florida is $15.78, according to ZipRecruiter salary data. Most workers in this role earn between $13.65 and $17.60 per hour, depending on experience, location, and employer.

What is a health claims job?

Health claims jobs involve processing, reviewing, and adjudicating insurance claims related to healthcare services. Professionals in these roles ensure that medical claims are accurate, complete, and comply with insurance policies and regulations. They often work for insurance companies, healthcare providers, or third-party administrators, and may interact with patients, healthcare professionals, and insurers to resolve issues or discrepancies. Common positions in this field include health claims processor, claims examiner, and claims adjuster. Attention to detail, knowledge of medical billing codes, and understanding of healthcare policies are essential for success in health claims jobs.

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

To thrive as a Health Claims Specialist, you need a solid understanding of medical terminology, insurance policies, and claims processing, usually supported by a high school diploma or associate degree in a related field. Familiarity with claims management software, electronic health records (EHR), and industry coding systems like ICD-10 and CPT is typically required. Attention to detail, analytical thinking, and effective communication are crucial soft skills for resolving discrepancies and interacting with providers or policyholders. These skills ensure accurate, efficient claims processing and help maintain compliance with healthcare regulations and customer satisfaction.

What are some common challenges faced by health claims professionals and how can they be managed?

Health claims professionals often encounter challenges such as processing high volumes of claims accurately and within tight deadlines, interpreting complex medical documentation, and staying updated with changing insurance regulations. Managing these challenges requires strong organizational skills, attention to detail, and continuous training on industry updates. Working closely with healthcare providers and other team members can also help clarify discrepancies and ensure claims are processed efficiently.

What is the difference between Health Claims vs Health Claims Specialist?

AspectHealth ClaimsHealth Claims Specialist
Required CredentialsTypically none or basic certificationsCertifications in health insurance, compliance, or related fields
Work EnvironmentInsurance companies, healthcare providers, government agenciesInsurance firms, healthcare organizations, regulatory bodies
Employer & Industry UsageUsed broadly in health insurance and healthcare sectorsSpecialized role focusing on claims processing and compliance
Common Search & ComparisonUnderstanding health claims processesRoles related to health claims management and review

Health Claims refer to the actual submissions or requests for reimbursement for healthcare services, while a Health Claims Specialist is a professional who reviews, processes, and ensures compliance of these claims. The specialist role involves expertise in insurance policies, regulations, and claims procedures, making it a more specialized position within the healthcare and insurance industries.

What does a health claims specialist do?

A health claims specialist reviews and evaluates insurance claims related to health services to determine coverage eligibility and accuracy. They analyze medical documentation, ensure compliance with policies and regulations, and often use claims processing software to manage cases efficiently.

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

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

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

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

Health Claims jobs near you
Infographic showing various Health Claims job openings in Florida as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, and 4% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $32,819 per year, or $15.8 per hour.

Senior Claims Auditor

Seminole Tribe of Florida

Hollywood, FL • On-site

Full-time

Medical

Re-posted 15 days ago

Job description

Position: Senior Claims Auditor
Job Type: Full Time
Department: Health & Human Services
Location: HOLLYWOOD
Posted: 02/23/2026
Job Description
The incumbent in this position is responsible for being the team lead in auditing and reviewing Tribal benefit activities and processing health claims, including analyzing payments, procedures and guidelines of benefits. The individual investigates the validity of claims, reviews and settles benefit claims and processes claims for payment ensuring that Tribal Member's health insurance claims are processed and resolved in a timely manner. The individual provides assistance and guidance to the Health Plan Program Manager, Health Plan team, Health & Human Services Leadership, Tribal Members and other relating employees on health insurance claims. The incumbent maintains accurate case files and issues reports on general claims activity. Bachelor's degree in Health Administration, Accounting, Business Administration, Human Resources Management or related field is required. A minimum of three (5) years of experience working as team lead, supervisor, claims auditor, benefits coordinator or experience processing insurance claims is required with at least two (2) years of experience as a Certified Professional Coder (CPC), is required. An equivalent combination of education/training and experience will be considered. Possession of a valid Florida Driver's License is required. Demonstrate excellent customer service and organizational skills. Demonstrate excellent written and verbal communication skills. Demonstrate proficiency utilizing Microsoft software packages. Ability to work a flexible schedule including evenings, weekends and holidays.
Benefits:
The Seminole Tribe of Florida provides a comprehensive benefits package.
The Seminole Tribe of Florida is a drug free workplace, drug screening is a requirement of employment. We exercise Native American preference.

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