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Insurance Claim Review Jobs in Florida (NOW HIRING)

CCMSI

Workers' Compensation Claim Consultant

Maitland, FL · On-site

$70K - $90K/yr

Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices ... Medical, Dental, Vision, Life, and Disability Insurance * Retirement plans : 401(k) and Employee ...

Zelis

Clinical Nurse Reviewer

Saint Petersburg, FL

Conduct prompt claim review to support internal inventory management to achieve greatest possible ... Experience and working knowledge of Health Insurance, Medicare guidelines and various healthcare ...

Zelis

Clinical Nurse Reviewer

Saint Petersburg, FL · On-site

Conduct prompt claim review to support internal inventory management to achieve greatest possible ... Experience and working knowledge of Health Insurance, Medicare guidelines and various healthcare ...

FCCI Insurance Group

Surety Claim Specialist

Sarasota, FL · On-site +1

$102K - $157K/yr

FCCI Insurance Group is a trusted provider of comprehensive property & casualty coverage in 20 ... reviews applicable statutes, and analyzes claim submissions involving commercial and contract ...

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Insurance Claim Review information

What is the difference between Insurance Claim Review vs Insurance Adjuster?

AspectInsurance Claim ReviewInsurance Adjuster
CredentialsTypically requires insurance or claims processing certificationsRequires licensing and adjuster certifications
Work EnvironmentOffice-based, reviewing claims remotely or on-siteFieldwork, inspecting damages, meeting clients
Employer & Industry UsageInsurance companies, third-party claims servicesInsurance companies, independent adjusting firms
Search & Comparison IntentUnderstanding claim review roles, job dutiesAssessing damage, settling claims

Insurance Claim Review professionals focus on evaluating and verifying insurance claims, often working in an office setting. Insurance Adjusters, on the other hand, inspect damages firsthand and negotiate settlements. Both roles require insurance-related certifications but differ in work environment and responsibilities.

What are the key skills and qualifications needed to thrive as an Insurance Claim Review Specialist, and why are they important?

To thrive as an Insurance Claim Review Specialist, you typically need a strong understanding of insurance policies, claims processes, and relevant regulations, often backed by a degree in business, finance, or a related field. Familiarity with claims management software, document management systems, and sometimes certifications such as AIC (Associate in Claims) are commonly required. Attention to detail, analytical thinking, and effective communication are critical soft skills for evaluating claims and interacting with policyholders. These skills ensure accurate, timely, and fair claim resolutions that uphold company standards and customer satisfaction.

What is insurance claim review?

Insurance claim review is the process by which insurance companies evaluate claims submitted by policyholders to determine their validity and the extent of coverage. Claims reviewers carefully examine documentation, such as medical records, police reports, or repair estimates, to ensure all policy requirements are met. This process helps prevent fraud, ensures claims are paid accurately, and maintains the integrity of the insurance system. Claim reviewers may also communicate with claimants, request additional information, or work with other professionals to make informed decisions.

What are some common challenges faced in an Insurance Claim Review role, and how can they be managed effectively?

One of the most common challenges in Insurance Claim Review is managing a high volume of claims while maintaining accuracy and compliance with regulatory standards. Claims can often be complex, requiring careful analysis of policy terms, medical or incident documentation, and communications with policyholders or third parties. Effective time management, attention to detail, and strong communication skills are essential. Collaborating closely with other departments, such as underwriting and legal, can also help resolve ambiguous cases more efficiently. Ongoing training and keeping up with changes in industry regulations further support success in this role.
What are popular job titles related to Insurance Claim Review jobs in Florida? For Insurance Claim Review jobs in Florida, the most frequently searched job titles are:
What job categories do people searching Insurance Claim Review jobs in Florida look for? The top searched job categories for Insurance Claim Review jobs in Florida are:
What cities in Florida are hiring for Insurance Claim Review jobs? Cities in Florida with the most Insurance Claim Review job openings:
Insurance Claim Review jobs near you
Infographic showing various Insurance Claim Review job openings in Florida as of July 2026, with employment types broken down into 78% Full Time, 19% Part Time, 1% Temporary, and 2% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution.
Quality Assurance Specialist - Home Inspections

Quality Assurance Specialist - Home Inspections

People's Trust Insurance Company

Deerfield Beach, FL • On-site

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

Job Title: Quality Assurance Specialist - Home Inspections
Deerfield Beach, FL | Onsite | Monday-Friday, 8:30 AM-5:00 PM
About the Role
We're looking for a highly detail-oriented and quality-driven individual to join our team as a Quality Assurance Specialist. In this role, you'll be responsible for auditing completed home inspections to ensure accuracy, compliance, and consistency with industry standards and internal procedures. You'll also contribute to our claims review process, comparing inspection findings with insurance claims to identify pre-existing damage and support legal documentation.
This is an essential role in maintaining the high standards we're known for-and we're looking for someone who takes pride in getting things right, down to the smallest detail.
What You'll Do
  • Audit inspection reports to verify completeness, accuracy, and adherence to our Standard Operating Procedures (SOPs).
  • Review various inspection types, including wind mitigations, four-point, roof certifications, opening protections, and full inside/outside inspections.
  • Provide feedback to inspectors on errors, inconsistencies, or missed items, helping to improve overall quality and compliance.
  • Support claims reviews by comparing inspection reports to insurance claim inspections, identifying pre-existing damages, and documenting findings clearly.
  • Work with leadership to present audit findings, highlight performance trends, and identify areas for improvement.
  • Recommend improvements to current QA processes and SOPs that help increase accuracy and efficiency.
  • Communicate with clients and agents to explain inspection outcomes and resolve concerns with professionalism.
  • Contribute to internal reporting, summarizing audit trends, inspector performance, and rejection reasons.
What We're Looking For
  • Experience in home inspections, quality assurance, or insurance claim review.
  • Strong understanding of home inspection types and standards (wind mitigation, four-point, etc.).
  • Analytical mindset with an eagle eye for details and inconsistencies.
  • Comfortable giving and receiving feedback with professionalism and clarity.
  • Ability to work independently but also collaborate effectively with management and team members.
  • Excellent communication and writing skills.
  • Familiarity with insurance claims, SOPs, and legal documentation is a plus.
  • A proactive, solutions-oriented mindset.
Why Join Us
  • Make a meaningful impact by helping ensure high-quality work that protects homeowners and supports accurate insurance decisions.
  • Be part of a supportive, quality-focused team where your attention to detail is truly valued.
  • Contribute to the development of new systems and processes as our company grows and evolves.

If you take pride in precision, are passionate about quality, and enjoy helping others improve, we'd love to hear from you. Apply today and be part of a team that sets the standard in home inspections.

Apply