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Health Insurance Adjuster Jobs in Florida (NOW HIRING)

Loyalty MGA LLC

Metal Adjuster

Miami, FL · On-site

$60 - $80/hr

Loyalty MGA is looking for experienced Bilingual Auto Insurance Adjusters to join our team onsite ... Insurance -- Comprehensive health coverage for you✓ Sick Time -- Dedicated sick time separate ...

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Health Insurance Adjuster information

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$14.6K

$55.8K

$82.6K

How much do health insurance adjuster jobs pay per year?

As of Sep 9, 2026, the average yearly pay for health insurance adjuster in Florida is $55,807.00, according to ZipRecruiter salary data. Most workers in this role earn between $35,900.00 and $74,700.00 per year, depending on experience, location, and employer.

What does a health insurance adjuster do?

A Health Insurance Adjuster is responsible for evaluating health insurance claims to determine the extent of the insurance company's liability. They review medical records, verify policy coverage, and communicate with healthcare providers, policyholders, and sometimes legal professionals. Their goal is to ensure claims are processed accurately and fairly, approving legitimate claims and identifying potential fraud or errors. Adjusters play a crucial role in helping policyholders receive the benefits they are entitled to while protecting the financial interests of the insurance company.

What are some typical challenges a health insurance adjuster faces when investigating claims?

Health Insurance Adjusters often encounter challenges such as interpreting complex policy language, verifying the legitimacy of medical claims, and balancing the needs of the claimant with company policies. They must evaluate detailed medical records, communicate with healthcare providers, and ensure compliance with ever-changing regulations. Navigating these complexities requires strong analytical skills, attention to detail, and effective communication to resolve claims fairly and efficiently.

What are the key skills and qualifications needed to thrive as a health insurance adjuster, and why are they important?

To thrive as a Health Insurance Adjuster, you need a strong understanding of insurance policies, claims processing, and relevant legal regulations, often supported by a bachelor's degree or industry-specific certifications. Familiarity with claims management software, medical billing systems, and regulatory databases is typically required. Attention to detail, negotiation skills, and effective communication are essential soft skills for evaluating claims and interacting with policyholders. These skills ensure accurate claims assessment, compliance with industry standards, and positive client relations, all of which are crucial for success in this role.

Is it hard to become a health insurance adjuster?

Becoming a health insurance adjuster typically requires completing state-specific licensing exams and training, which can vary in difficulty depending on the individual's background and familiarity with insurance concepts. Strong analytical skills, attention to detail, and knowledge of insurance policies are important, and some states may require prior experience or coursework before licensing.

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

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

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

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

What cities in Florida are hiring for Health Insurance Adjuster jobs?

Cities in Florida with the most Health Insurance Adjuster job openings:

Health Insurance Adjuster jobs near you
Infographic showing various Health Insurance Adjuster job openings in Florida as of September 2026, with employment types broken down into 2% As Needed, 79% Full Time, 15% Part Time, and 4% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $55,807 per year, or $26.8 per hour.

Medical Health Insurance Claims Adjuster

Clearwater, FL • On-site

Integrity Marketing Group
See more jobs at Integrity Marketing Groupexternal

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 5 days ago

Integrity Marketing Group rating

7.7

Company rating: 7.7 out of 10

Based on 34 frontline employees who took The Breakroom Quiz

17th of 52 rated marketing agency

Job description

Health Insurance Claims Adjuster
Insurance Administrative Solutions
Clearwater, FL
About Insurance Administrative Solutions
Insurance Administrative Solutions, L.L.C. ("IAS"), an Integrity company headquartered in Clearwater, Florida, is a third-party administrator providing business process outsourcing for insurance carriers. Formed in 2002, IAS administers policies for insureds residing all across the United States.
Job Summary: Analyze medical claims to determine the extent of insurance carrier liability. Interpret contract benefits in accordance with specific claims processing guidelines.
Primary Responsibilities other duties may be assigned as necessary:
  • Examine/perform/research & make decisions necessary to properly adjudicate claims and written inquiries.
  • Receive, organize and make daily use of information regarding benefits, contract coverage, and policy decisions.
  • Interpret contract benefits in accordance with specific claim processing guidelines.
  • Coordinate daily workflow to coincide with check cycle days to meet all service guarantees.
  • Based on established guidelines and/or historical knowledge an adjuster will need to recognize red flags for potential fraud or waste and escalate accordingly.
  • Adjusters who handle the potential fraud or waste claims will investigate, track via clear and complete system notes and accurately report on each file/case in a timely manner.
  • Understand broad strategic concept of our business and link these to the day-to-day business functions of claims processing.
  • Maintain external contact with providers/agents/policyholders.

Primary Skills & Requirements: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.
  • A high school diploma or GED equivalent
  • Minimum of 1 year proven health insurance claims adjudication experience.
  • Insurance background preferred; previous Medical/prescription claims preferred.
  • Experience with UB/institutional (CMS-1450) and HCFA/professional (CMS-1500) claims required.
  • Familiarity with medical terminology, procedures and diagnosis codes preferred.
  • Ability to read and interpret EOB's claim history, and excellent research skills.
  • Familiarity with Microsoft Office products; familiarity with Qiclink software a plus.
  • Ability to calculate deductible and co-insurance amounts.
  • Ability to adapt and respond to different types of people and tasks.
  • Excellent communication and documentation skills.
  • Ability to multi-task, prioritize, and manage time effectively and efficiently.
  • Reliable transportation and the ability to be punctual and dependable.

Benefits Available
  • We value flexibility and recognize the importance of work-life balance. This role will begin as fully onsite to support learning and team integration. As proficiency is demonstrated, hybrid work opportunities may be introduced, dependent on business needs and department practices.
  • Medical/Dental/Vision Insurance
  • 401(k) Retirement Plan
  • Paid Holidays
  • PTO
  • Community Service PTO
  • FSA/HSA
  • Life Insurance
  • Short-Term and Long-Term Disability

About Integrity
Integrity is one of the nation's leading independent distributors of life, health and wealth insurance products. With a strong insurtech focus, we embrace a broad and innovative approach to serving agents and clients alike. Integrity is driven by a singular purpose: to help people protect their life, health and wealth so they can prepare for the good days ahead.
Integrity offers you the opportunity to start a career in a family-like environment that is rewarding and cutting edge. Why? Because we put our people first! At Integrity, you can start a new career path at company you'll love, and we'll love you back. We're proud of the work we do and the culture we've built, where we celebrate your hard work and support you daily. Joining us means being part of a hyper-growth company with tons of professional opportunities for you to accelerate your career. Integrity offers our people a competitive compensation package, including benefits that make work more fun and give you and your family peace of mind.
Headquartered in Dallas, Texas, Integrity is committed to meeting Americans wherever they are - in person, over the phone or online. Integrity's employees support hundreds of thousands of independent agents who serve the needs of millions of clients nationwide. For more information, visit Integrity.com.
Integrity, LLC is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, national origin, disability, veteran status, or any other characteristic protected by federal, state, or local law. In addition, Integrity, LLC will provide reasonable accommodations for qualified individuals with disabilities.

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