ZipRecruiter

Log In

1

Insurance Claims Examiner Jobs in Florida (NOW HIRING)

Independent Living Systems

Claims Examiner

Miami, FL · On-site

The Claims Examiner plays an essential role by thoroughly reviewing and evaluating insurance claims to ensure accuracy, compliance, and appropriateness of payments. This position involves analyzing ...

Independent Living Systems

Claims Examiner

Miami, FL · On-site

The Claims Examiner plays an essential role by thoroughly reviewing and evaluating insurance claims to ensure accuracy, compliance, and appropriateness of payments. This position involves analyzing ...

Wellcove

Claims - Claims Examiner

Pensacola, FL · On-site

Our solutions span the insurance senior market sector, focusing on long-term care and Medicare ... The Long-Term Care (LTC) Claims Examiner is responsible for the accurate and timely adjudication of ...

GEICO

Injury Claims Examiner

Saint Petersburg, FL · On-site

As an Injury Claims Examiner, your ability to provide exemplary service and technical expertise to ... Understanding and ability to execute and comply with Department of Insurance Guidelines and ...

GEICO

Injury Claims Examiner

Saint Petersburg, FL · On-site

As an Injury Claims Examiner, your ability to provide exemplary service and technical expertise to ... Understanding and ability to execute and comply with Department of Insurance Guidelines and ...

GEICO

Injury Claims Examiner

Tampa, FL · On-site

As an Injury Claims Examiner, your ability to provide exemplary service and technical expertise to ... Understanding and ability to execute and comply with Department of Insurance Guidelines and ...

GEICO

Injury Claims Examiner

Tampa, FL · On-site

As an Injury Claims Examiner, your ability to provide exemplary service and technical expertise to ... Understanding and ability to execute and comply with Department of Insurance Guidelines and ...

GEICO

Injury Claims Examiner

Largo, FL · On-site

As an Injury Claims Examiner, your ability to provide exemplary service and technical expertise to ... Understanding and ability to execute and comply with Department of Insurance Guidelines and ...

GEICO

Injury Claims Examiner

Riverview, FL · On-site

As an Injury Claims Examiner, your ability to provide exemplary service and technical expertise to ... Understanding and ability to execute and comply with Department of Insurance Guidelines and ...

GEICO

Injury Claims Examiner

Riverview, FL · On-site

As an Injury Claims Examiner, your ability to provide exemplary service and technical expertise to ... Understanding and ability to execute and comply with Department of Insurance Guidelines and ...

next page

Showing results 1-20

All JobsInsurance Claims Examiner JobsInsurance Claims Examiner Jobs in Florida

Insurance Claims Examiner information

See Florida salary details

$29.9K

$46K

$68.8K

How much do insurance claims examiner jobs pay per year?

As of Sep 6, 2026, the average yearly pay for insurance claims examiner in Florida is $46,033.00, according to ZipRecruiter salary data. Most workers in this role earn between $40,400.00 and $48,900.00 per year, depending on experience, location, and employer.

What does an insurance claims examiner do?

An Insurance Claims Examiner is responsible for reviewing insurance claims to determine their validity and ensure that payouts are made according to policy guidelines. They investigate the details of claims, verify information, and may consult with medical or legal experts. The examiner determines if claims are covered, recommends approval or denial, and helps prevent fraudulent or excessive claims. Their work ensures that policyholders receive fair treatment while protecting the insurance company's financial interests.

What are some common challenges insurance claims examiners face in their daily work?

Insurance Claims Examiners often encounter the challenge of balancing thorough investigation with timely claims processing. Reviewing complex documentation, communicating with claimants and other stakeholders, and detecting potential fraud can be demanding, especially when managing a high-volume caseload. Examiners must stay updated on changing regulations and policy guidelines while maintaining objectivity and empathy in sometimes stressful situations. Developing strong organizational and communication skills is key to overcoming these challenges and delivering fair, accurate outcomes.

What are the key skills and qualifications needed to thrive as an insurance claims examiner, and why are they important?

To thrive as an Insurance Claims Examiner, you need a solid understanding of insurance policies, claim procedures, and investigative techniques, typically supported by a bachelor's degree in a related field. Familiarity with claims management software, regulatory compliance tools, and sometimes certifications like AIC (Associate in Claims) are commonly required. Attention to detail, analytical thinking, and effective communication are crucial soft skills for evaluating claims and interacting with claimants and stakeholders. These skills ensure accurate claim assessments, minimize fraudulent payouts, and maintain trust with clients and insurers.

What is the difference between Insurance Claims Examiner vs Insurance Adjuster?

AspectInsurance Claims ExaminerInsurance Adjuster
CredentialsTypically requires a high school diploma or equivalent; some roles prefer certifications like CPCU or AICRequires similar credentials; certifications like AIC or CPCU are common
Work EnvironmentOffice-based, reviewing claims and documentationField or office-based, inspecting damages and interviewing claimants
Employer & IndustryInsurance companies, government agenciesInsurance companies, independent adjusting firms
Search & Comparison IntentOften compared for claims processing rolesRelated to claims evaluation and damage assessment

Both Insurance Claims Examiners and Insurance Adjusters work within the insurance industry, handling claims and requiring similar certifications. While Claims Examiners primarily review documentation in office settings, Adjusters often inspect damages in the field. Understanding these differences helps job seekers identify the right role based on work environment and responsibilities.

How much do insurance claims examiners make in the US?

Insurance claims examiners in the US earn a median annual salary of around $45,000 to $70,000, depending on experience, location, and employer. Those with specialized skills or certifications can earn higher wages, and the role often involves reviewing claims, assessing damages, and ensuring compliance with policies.

How to become an insurance claims examiner?

To become an insurance claims examiner, candidates typically need a high school diploma or equivalent, with some roles preferring postsecondary education or relevant experience. Many employers require knowledge of insurance policies, strong analytical skills, and attention to detail; professional certifications such as the Chartered Property Casualty Underwriter (CPCU) can enhance prospects. On-the-job training is common, and familiarity with claims processing software is beneficial.

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

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

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

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

What are popular job titles related to Insurance Claims Examiner jobs in FL?

For Insurance Claims Examiner jobs in FL, the most frequently searched job titles are:

Insurance Claims Examiner jobs near you
Infographic showing various Insurance Claims Examiner job openings in Florida as of August 2026, with employment types broken down into 1% As Needed, 75% Full Time, 19% Part Time, and 5% Contract. Highlights an 85% Physical, 1% Hybrid, and 14% Remote job distribution, with an average salary of $46,033 per year, or $22.1 per hour.

Claims Examiner

Independent Living Systems

Miami, FL • On-site

Full-time

Posted 8 days ago

Independent Living Systems rating

6.5

Company rating: 6.5 out of 10

Based on 9 frontline employees who took The Breakroom Quiz

Job description

We are seeking a Claims Examiner to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.

About the Role:

The Claims Examiner plays an essential role by thoroughly reviewing and evaluating insurance claims to ensure accuracy, compliance, and appropriateness of payments. This position involves analyzing medical documentation, policy details, and billing information to determine the validity of claims and identify any discrepancies or potential fraud. The Claims Examiner collaborates with healthcare providers, and internal teams to resolve claim issues and facilitate timely reimbursement. By maintaining up-to-date knowledge of healthcare regulations and insurance policies, the Claims Examiner helps protect the organization from financial loss and supports the delivery of fair and efficient claims processing. Ultimately, this role contributes to the integrity and sustainability of the organization by ensuring claims are processed accurately and ethically.

Minimum Qualifications:

  • High school diploma or GED.
  • Minimum of 2 years experience in claims examination, medical billing, or healthcare insurance processing.
  • Strong understanding of medical terminology, insurance policies, and healthcare billing codes (e.g., ICD-10, CPT).
  • Proficiency with claims management software and Microsoft Office suite.

Preferred Qualifications:

  • Associate’s degree or Bachelor's degree in health administration, healthcare management, or a related discipline.
  • Certification such as Certified Professional Coder (CPC) or Certified Claims Professional (CCP).
  • Experience working within the health care and social assistance industry or with government healthcare programs.
  • Familiarity with regulatory frameworks such as HIPAA and the Affordable Care Act.

Responsibilities:

  • Demonstrate commitment to Our Mission and models ILS Experience Standards of Excellence.
  • Review and analyze health insurance claims for completeness, accuracy, and compliance with policy terms and regulatory requirements.
  • Verify medical codes, treatment documentation, and billing information to ensure services are properly covered and billed.
  • Investigate and resolve claim discrepancies by communicating with providers and internal stakeholders.
  • Identify and escalate potential fraudulent claims or billing errors to compliance or legal teams.
  • Maintain detailed records of claim evaluations and stay current with healthcare laws and industry standards to support audits and improve processing workflows.
  • Perform other duties as assigned.



What Independent Living Systems employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom