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Insurance Claims Processing Jobs in Boca Raton, FL

Seminole Tribe of Florida

Claims Auditor

Hollywood, FL · On-site

The individual investigates the validity of claims, reviews and settles benefit claims and processes claims for payment ensuring that STOF employees and Tribal Member's health insurance claims are ...

Dania Discount Drugs Inc

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Pharmacy Technician

Fort Lauderdale, FL · On-site

$18 - $22.50/hr

We are looking for a pharmacy technician with experience in data entry and insurance claims processing. You will be required to perform data entry and insurance adjudication of claims, fill ...

Dania Discount Drugs Inc

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Pharmacy Technician

Fort Lauderdale, FL · On-site

$18 - $22.50/hr

We are looking for a pharmacy technician with experience in data entry and insurance claims processing. You will be required to perform data entry and insurance adjudication of claims, fill ...

Fort Lauderdale OMS

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Dental Front Desk Receptionist

Fort Lauderdale, FL · On-site

$25K - $32K/yr

Knowledge of dental/medical insurance billing and claims processing * Strong communication and customer service skills * Excellent organizational and multitasking abilities * Familiarity with ...

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All JobsInsurance Claims Processing JobsInsurance Claims Processing Jobs in Boca Raton, FL

Insurance Claims Processing information

See Boca Raton, FL salary details

$11

$21

$32

How much do insurance claims processing jobs pay per hour?

As of Jun 10, 2026, the average hourly pay for insurance claims processing in Boca Raton, FL is $21.20, according to ZipRecruiter salary data. Most workers in this role earn between $17.36 and $24.18 per hour, depending on experience, location, and employer.

What is insurance claims processing?

Insurance claims processing is the procedure by which insurance companies review, investigate, and settle claims made by policyholders. This process involves verifying the details of a claim, ensuring it meets the terms of the policy, and determining the appropriate payout or action. Claims processors handle documentation, communicate with claimants, and may work with other parties like adjusters or healthcare providers. The goal is to ensure claims are resolved efficiently, accurately, and fairly according to policy guidelines.

What are some common challenges faced in insurance claims processing, and how can new team members effectively manage them?

In insurance claims processing, new team members often encounter challenges such as handling high volumes of claims, interpreting complex policy language, and communicating effectively with policyholders and other stakeholders. To manage these challenges, it's important to develop strong organizational skills, stay detail-oriented, and proactively seek clarification when unsure about policy terms or procedures. Collaborating with experienced colleagues and taking advantage of ongoing training opportunities can also help new processors build confidence and efficiency in their daily tasks.

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

AspectInsurance Claims ProcessingInsurance Adjuster
CredentialsTypically requires a high school diploma or equivalent; certifications like CPCU or AIC are commonRequires a high school diploma; certifications like AIC or state licensing often needed
Work EnvironmentOffice-based, processing claims via computer systemsField and office work, inspecting damages and interviewing claimants
Employer & Industry UsageInsurance companies, third-party administratorsInsurance companies, independent adjusting firms
Primary FocusReviewing and processing insurance claims efficientlyAssessing damages and determining claim validity and payout

While both roles are essential in the insurance industry, Insurance Claims Processing focuses on handling and managing claims paperwork, whereas Insurance Adjusters evaluate damages and determine claim settlements. Understanding these differences helps job seekers identify the right career path within the insurance sector.

What are the key skills and qualifications needed to thrive in Insurance Claims Processing, and why are they important?

To excel in Insurance Claims Processing, you need strong attention to detail, analytical abilities, and a foundational understanding of insurance policies or claims procedures, often supported by a high school diploma or associate degree. Familiarity with claims management software, databases, and sometimes industry certifications like AIC (Associate in Claims) is common. Effective communication, problem-solving skills, and the ability to manage stressful situations make someone stand out in this role. These competencies are critical for ensuring claims are processed accurately, efficiently, and in compliance with regulatory standards.
What job categories do people searching Insurance Claims Processing jobs in Boca Raton, FL look for? The top searched job categories for Insurance Claims Processing jobs in Boca Raton, FL are:
What cities near Boca Raton, FL are hiring for Insurance Claims Processing jobs? Cities near Boca Raton, FL with the most Insurance Claims Processing job openings:
Insurance Claims Processing jobs near you

PIP Claims Adjuster (On-site)

Policy Services Company LLC

Coral Springs, FL • On-site

$50K - $70K/yr

Full-time

Posted 18 days ago

Job description

Description:


Position Summary

The ideal candidate is an experienced, all-lines adjuster, with at least one year of PIP handling experience for Florida PIP claims, specifically with experience clearing coverage and qualifying claimants for benefits under the policy. The candidate has a strong background in insurance claims processing, excellent communication skills, and the ability to handle complex situations with empathy and professionalism. Adjusters are responsible for assigned files within their department matched to their expertise in claims handling. They must follow protocols set forth by department supervisors/managers and operate within their stated authority and handle claims in accordance with the Florida adjuster code of ethics.


Essential Duties and Functions

The essential functions include, but are not limited to the following:

· Evaluate auto insurance claims promptly and accurately to determine coverage, liability, and settlement options.

· Conduct thorough investigations into the circumstances surrounding each claim, including obtaining statements, collecting evidence, and analyzing policy provisions.

· Maintain detailed and organized claim files, documenting all relevant information, correspondence, and decisions made throughout the claims process.

· Communicate effectively with policyholders, claimants, witnesses, and other involved parties to gather information, explain coverage, and provide updates on claim status.

· Negotiate settlements within authorized limits, considering factors such as liability, damages, and policy coverage.

· Provide exceptional customer service to policyholders and claimants, addressing inquiries, concerns, and complaints in a timely and professional manner.

· Ensure compliance with insurance regulations, company policies, and industry standards in all aspects of claims handling.

· Collaborate with internal teams, including underwriters, legal counsel, and other claims professionals, to resolve complex claims and mitigate risk effectively.

· Identify opportunities for process improvement and contribute to the development of best practices within the claims department.

· Perform quality reviews of claim files to ensure accuracy, consistency, and adherence to company guidelines.

· Ensure timecards are reviewed daily for accurate hours worked.

Requirements:

Minimum Qualifications (Knowledge, Skills, and Responsibilities)

· Strong knowledge of insurance principles, regulations, and industry standards.

· Excellent analytical skills with the ability to assess liability and evaluate damages.

· Exceptional communication and interpersonal skills, both written and verbal.

· Proficiency in insurance claims software, preferably Microsoft Office suite.

· Demonstrated ability to manage multiple priorities and meet deadlines in a fast-paced environment.

· Commitment to providing outstanding customer service and maintaining professionalism in challenging situations.

Required Education and Experience:

· High School Diploma or equivalent experience in auto claims insurance, business administration, or a related field; Bachelor’s or Associates degree preferred.

· Minimum of 1+ years of PIP handling experience for Florida PIP claims

· Florida Adjuster License.