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Health Insurance Claims Processor Jobs in Florida

CorVel Enterprise Claims, Inc.

Claims Specialist

Tampa, FL · Hybrid

$52K - $85K/yr

... process taking into consideration experience, qualifications, and overall fit for the role. The ... Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance ...

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All JobsHealth Insurance Claims Processor JobsHealth Insurance Claims Processor Jobs in Florida

Health Insurance Claims Processor information

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How much do health insurance claims processor jobs pay per hour?

As of Aug 6, 2026, the average hourly pay for health insurance claims processor in Florida is $16.69, according to ZipRecruiter salary data. Most workers in this role earn between $13.65 and $19.04 per hour, depending on experience, location, and employer.

What is the difference between Health Insurance Claims Processor vs Medical Billing Specialist?

AspectHealth Insurance Claims ProcessorMedical Billing Specialist
CredentialsHigh school diploma; certifications like Certified Claims Professional (CCP)High school diploma; certifications like Certified Medical Billing Specialist (CMBS)
Work EnvironmentInsurance companies, healthcare providers, claims departmentsMedical offices, billing companies, healthcare facilities
Primary ResponsibilitiesReview and process insurance claims, ensure accuracy, follow up on denialsPrepare and submit medical bills, verify insurance coverage, manage patient accounts

While both roles involve handling healthcare financial transactions, the Health Insurance Claims Processor primarily focuses on reviewing and processing insurance claims submitted by providers, whereas the Medical Billing Specialist manages the billing process from patient registration to payment collection. Both roles require knowledge of insurance policies and coding, but their daily tasks and work environments differ slightly.

Is a health insurance claims processor job in demand?

Health insurance claims processor jobs are in steady demand due to the ongoing need for healthcare administration and insurance processing. Employment in this field is expected to grow as healthcare coverage expands and companies seek skilled workers familiar with claims software and regulations.

What does a health insurance claims processor do?

A Health Insurance Claims Processor reviews and evaluates insurance claims submitted by policyholders or healthcare providers. They verify the accuracy of the information, ensure that the claims comply with policy terms, and determine the amount payable for each claim. Claims processors may also correspond with providers or claimants for additional documentation, resolve discrepancies, and help prevent fraudulent claims. Their work ensures that claims are processed efficiently and payments are made accurately according to insurance policies.

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

To thrive as a Health Insurance Claims Processor, you need attention to detail, knowledge of insurance policies and medical terminology, and typically a high school diploma or equivalent. Familiarity with claims management software, electronic health record (EHR) systems, and basic coding (ICD-10, CPT) is standard in this role. Strong organizational skills, problem-solving abilities, and effective communication help you manage claims efficiently and resolve discrepancies. These competencies ensure accurate processing, minimize errors, and support timely reimbursement within the healthcare system.

How to become a health insurance claims processor?

To become a health insurance claims processor, candidates typically need a high school diploma or equivalent and should develop skills in data entry, attention to detail, and knowledge of insurance policies. Some employers prefer candidates with postsecondary education or certifications in health insurance or medical billing, and on-the-job training is common. Proficiency with claims processing software and understanding of healthcare terminology are also beneficial.

What are some common challenges health insurance claims processors face, and how can they effectively manage them?

Health Insurance Claims Processors often encounter challenges such as interpreting complex policy language, managing high volumes of claims, and ensuring compliance with changing regulations. To effectively manage these challenges, processors benefit from developing strong attention to detail, staying up to date with industry guidelines, and utilizing time management strategies. Collaboration with other departments such as customer service and medical coding teams is also key to resolving discrepancies and ensuring accurate claim outcomes.
What are popular job titles related to Health Insurance Claims Processor jobs in Florida? For Health Insurance Claims Processor jobs in Florida, the most frequently searched job titles are:
What job categories do people searching Health Insurance Claims Processor jobs in Florida look for? The top searched job categories for Health Insurance Claims Processor jobs in Florida are:
Health Insurance Claims Processor jobs near you
Infographic showing various Health Insurance Claims Processor job openings in Florida as of July 2026, with employment types broken down into 1% As Needed, 79% Full Time, 16% Part Time, and 4% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $34,720 per year, or $16.7 per hour.

Property & Casualty Claims Executive

Higginbotham Insurance Agency

Lakeland, FL

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 19 days ago

Job description

Position Summary:  The Claims Executive is responsible for accurate reporting and filing of claim litigation to the respective Carrier, in addition to handling complex claims scenarios along with resolution of claims disputes. The Claims Executive functions as an insurance claims professional that provides guidance to the Customers and Producers on more complex claims issues. Claims Executive is responsible for monitoring the assigned inventory of accounts, answering phone calls, consulting on claims related issues. Duties include; handling customer service calls as needed, reviewing claims on an as needed basis.

Essential Tasks:

  • Reports to the Claims Operations Manager on workflow issues and the handling of assigned claims inventory
  • Service and be the point of contact for assigned threshold accounts.
  • Ability to review policy language and offer a professional opinion regarding coverage, settlements, reserve practices, etc.
  • Handle and work with carrier and client on professional coverages, including D&O and EPL.
  • Ability to troubleshoot and consult clients on all P&C lines, including disputes or denials by the carrier.
  • Review, document and acknowledge Pre- Litigation request or demands.
  • Must be able to understand report, monitor and be able to consult clients on any Litigation Claims brought to Suit.
  • Proficient in excel with the capability to produce charts and presentations.
  • Perform claims reviews and loss analysis for assigned threshold accounts.
  • Must be comfortable in presentations to prospects and existing clients.
  • Travel as needed to support existing clients as well as company growth goals.
  • Ability to work both in a team environment and independently with minimal supervision
  • Must have excellent time management skills with the ability to multi task and calendar client service plans
  • Takes ownership of the total work process and provides constructive information to minimize problems and increase customer satisfaction
  • Performs all other related duties as assigned

Core Competencies:

  • Ability to Analyze and Solve Problems: Skill in recognizing challenges, exploring options, and implementing effective solutions in a timely manner
  • Attention to Detail: A strong focus on completing tasks and projects accurately and thoroughly
  • Communication Skills: Capable of expressing ideas clearly in both verbal and written forms and engaging with various audiences
  • Timely Task Completion: Ability to finish tasks and projects efficiently, managing resources and priorities effectively
  • Team Collaboration: Willingness to work together with others, promoting teamwork and supporting shared goals
  • Client Focus: Dedication to understanding and addressing the needs of clients and stakeholders to ensure their satisfaction
  • Dependability: Acknowledgment of the importance of being present and punctual.
  • Creative Thinking: Openness to suggesting new ideas and methods to improve processes and outcome
  • Organizational Skills: Capability to prioritize tasks and manage multiple projects simultaneously
  • Adaptability: Willingness to adjust to changing situations and priorities, showing resilience in a dynamic work environment

Experience and Education:

  • Bachelor’s Degree and at least 5 years of experience in the related field
  • 3+ years of claims processing experience
  • Insurance Claims terminology
  • Proficient with Claims processing guidelines, working knowledge of claims settlement and insurance claims practices
  • Ability to organize, prioritize and communicate effectively while meeting deadlines and production goals
  • Must have commonly-used knowledge of claims examination concepts, practices and rules and claims workflows. This position utilizes experience and judgment to plan, accomplish goals and effectively solve problems with a variety of scenarios
  • Advanced training in claims processes preferred

Licensing and Credentials:

  • Adjusters License
  • Previous litigation and insurance claims experience preferred

Systems:

  • Proficient with Microsoft Excel, Word, PowerPoint, and Outlook
  • Applied Epic experience preferred, but knowledge of similar Account Management System (AMS) is acceptable

    Physical Requirements:

    • Ability to lift 25 pounds
    • Repeated use of sight to read documents and computer screens
    • Repeated use of hearing and speech to communicate on telephone and in person
    • Repetitive hand movements, such as keyboarding, writing, 10-key
    • Walking, bending, sitting, reaching and stretching in all directions 

    Benefits & Compensation: 

    • Higginbotham offers medical, dental, vision, prescription drug coverage, 401K, equity incentive plan as well as multiple supplemental benefits for physical, emotional, and financial wellbeing. 
    • Employee Wellness Program 
    • Company paid holidays, plus PTO 

    Notice to Recruiters and Staffing Agencies: To protect the interests of all parties, Higginbotham Insurance Agency, Inc., and our partners, will not accept unsolicited potential placements from any source other than directly from the candidate or a vendor partner under MSA with Higginbotham.  Please do not contact or send unsolicited potential placements to our team members.

    *Applications will be accepted until the position is filled 

    Apply