ZipRecruiter

Log In

1

Healthcare Claims Processing Jobs in Florida (NOW HIRING)

ttg Talent Solutions

Medical Claims Processor

Doral, FL

$22 - $23/hr

High school diploma or equivalent; college degree preferred. * 2-4 years of healthcare or managed care claims processing experience. * Strong knowledge of Medicare and DSNP claims. * Experience with ...

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 ...

Miccosukee Tribe of Indians

Be Seen First

Claims Processor

Miami, FL · On-site

$24 - $27/hr

... processing, submission, monitoring, and follow-up of healthcare claims to Medicare, Medicaid, and other third-party payers. This position supports the Health Department's revenue cycle by helping ...

Wellcove

Claims - Claims Examiner

Pensacola, FL · On-site

High school diploma or equivalent required; associate or bachelor's degree preferred * 2+ years of experience in insurance claims, healthcare administration, or Long-Term Care claims processing

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 ...

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 ...

Independent Living Systems

Claims Auditor

Miami, FL · On-site

By collaborating with claims processors, healthcare providers, and compliance teams, the auditor helps to streamline claims management and reduce errors. Ultimately, this role supports the delivery ...

Independent Living Systems

Claims Auditor

Miami, FL · On-site

By collaborating with claims processors, healthcare providers, and compliance teams, the auditor helps to streamline claims management and reduce errors. Ultimately, this role supports the delivery ...

next page

Showing results 1-20

All JobsHealthcare Claims Processing JobsHealthcare Claims Processing Jobs in Florida

Healthcare Claims Processing information

What is healthcare claims processing?

Healthcare claims processing is the administrative procedure by which insurance companies review and determine whether to pay for medical services provided to patients. This process involves submitting, analyzing, and either approving or denying claims submitted by healthcare providers on behalf of patients. Claims processors verify patient information, check coverage details, and ensure that services are medically necessary and properly documented. Accurate and timely claims processing is essential for both healthcare providers and patients to ensure services are paid for according to insurance policies.

What are some common challenges faced in healthcare claims processing, and how can a new employee prepare to handle them?

Healthcare claims processors often encounter challenges such as interpreting complex insurance policies, identifying errors or discrepancies in submitted claims, and keeping up with frequent regulatory changes. New employees can prepare by developing strong attention to detail, familiarizing themselves with medical terminology, and staying current on industry guidelines. Additionally, effective communication and collaboration with providers, insurers, and team members are key to resolving issues quickly and accurately.

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

To thrive in Healthcare Claims Processing, you need a solid understanding of medical billing, insurance policies, and healthcare regulations, often supported by relevant coursework or certification. Familiarity with claims management software, coding systems like ICD-10 and CPT, and electronic data interchange (EDI) platforms is typically required. Attention to detail, analytical thinking, and strong organizational skills are crucial soft skills for this role. These abilities ensure accurate and timely claims processing, minimizing errors and optimizing reimbursement for healthcare providers.

What is the difference between Healthcare Claims Processing vs Medical Billing Specialist?

AspectHealthcare Claims ProcessingMedical Billing Specialist
Primary RoleReviewing and submitting insurance claims for reimbursementCreating and managing patient invoices and billing records
CredentialsKnowledge of insurance policies, coding, and claims softwareKnowledge of billing procedures, coding, and insurance requirements
Work EnvironmentHealthcare facilities, insurance companies, or billing companiesMedical offices, hospitals, or billing service providers
Industry UsageUsed across healthcare providers and insurance payersPrimarily in healthcare provider settings

While both roles involve coding and insurance knowledge, Healthcare Claims Processing focuses on submitting and managing insurance claims, whereas Medical Billing Specialists handle patient billing and invoicing. Both roles are essential for revenue cycle management in healthcare organizations.

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

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

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

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

Healthcare Claims Processing jobs near you
Infographic showing various Healthcare Claims Processing job openings in Florida as of August 2026, with employment types broken down into 2% As Needed, 70% Full Time, 14% Part Time, and 14% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution.

Medical Claims Processor

ttg Talent Solutions

Doral, FL

$22 - $23/hr

Full-time

Posted 11 days ago

Job description

Medical Claims Processor
Location: Doral, FL on-site
Schedule: Full-Time | 40 hours per week; schedule may vary based on business needs, including occasional weekends, holidays, and overtime
Type of Contract: Full-Time
Pay Rate: $21 - $23.00 per hour
 
Description
We are seeking a detail-oriented Claims Examiner I to process and adjudicate healthcare claims, primarily Medicare and DSNP, within a managed care environment. The ideal candidate has healthcare claims experience, strong Medicare knowledge, and experience with disputes, appeals, COB, coding, and reimbursement.
Responsibilities
  • Review, adjudicate, and reprocess Medicare and DSNP claims accurately.
  • Handle disputes, reconsiderations, appeals, and claim adjustments.
  • Apply benefits, COB, coding edits, provider contracts, and fee schedules.
  • Ensure compliance with CMS, state regulations, and internal policies.
  • Identify and escalate complex claims or system issues.
  • Maintain accuracy, productivity, documentation, and turnaround standards.
  • Collaborate with internal teams to resolve claim-related issues.
Requirements
  • High school diploma or equivalent; college degree preferred.
  • 2–4 years of healthcare or managed care claims processing experience.
  • Strong knowledge of Medicare and DSNP claims.
  • Experience with claims adjudication, reprocessing, disputes, appeals, and COB.
  • Familiarity with CPT, HCPCS, and ICD-10 coding.
  • Understanding of provider contracts, fee schedules, and reimbursement.
  • Strong analytical, organizational, and problem-solving skills.
  • High attention to detail and ability to work in a fast-paced environment.
Preferred
  • Knowledge of CMS regulations and audits.
  • Experience with dual-eligible populations and Medicare Part C.
 
At ttg, "We believe in making a difference One Person at a Time," ttg OPT.
IND3