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Insurance Claims Processing Jobs in Boca Raton, FL

Pediatric Associates

Reimbursement Specialist

Plantation, FL · On-site

$18.25 - $25.25/hr

Processes correspondence related to assigned contracted and/or non-contracted insurance carriers including self-pay accounts. * Researches denied and improperly processed claims by contacting ...

Pediatric Associates

Reimbursement Specialist

Plantation, FL · On-site

$18.25 - $25.25/hr

Processes correspondence related to assigned contracted and/or non-contracted insurance carriers including self-pay accounts. * Researches denied and improperly processed claims by contacting ...

Pediatric Associates

Reimbursement Specialist

Plantation, FL · On-site

$18.25 - $25.25/hr

Processes correspondence related to assigned contracted and/or non-contracted insurance carriers including self-pay accounts. * Researches denied and improperly processed claims by contacting ...

Pediatric Associates

Reimbursement Specialist

Plantation, FL · On-site

$18.25 - $25.25/hr

Processes correspondence related to assigned contracted and/or non-contracted insurance carriers including self-pay accounts. * Researches denied and improperly processed claims by contacting ...

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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 Aug 15, 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 does an insurance claims processing do?

An insurance claims processor reviews and evaluates insurance claims to determine coverage eligibility and the amount payable. They verify information, process documentation, and communicate decisions to policyholders, often using claims management software. Attention to detail and knowledge of insurance policies are essential for this role.

How to get a job as an insurance claims processor?

To become an insurance claims processor, candidates typically need a high school diploma or equivalent, with some roles preferring postsecondary training in insurance or related fields. Relevant skills include attention to detail, communication, and familiarity with claims processing software. Gaining experience through internships or entry-level positions can improve job prospects, and some employers may require certification such as the Certified Claims Professional (CCP).

Is insurance claims processing a stressful job?

Insurance claims processing can be a stressful job due to tight deadlines, high workload, and the need for accuracy in evaluating claims. It often requires strong attention to detail, communication skills, and the ability to handle difficult customer interactions, which can contribute to job-related stress.

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?

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 are popular job titles related to Insurance Claims Processing jobs in Boca Raton, FL?

For Insurance Claims Processing jobs in Boca Raton, FL, the most frequently searched job titles are:

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

Insurance Verification Specialist

Quest Health Solutions LLC

Pompano Beach, FL • On-site

$16 - $19.75/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 29 days ago

Job description

Description:

Overview of the role

The Insurance Verification Specialist (IVS) is responsible for verifying insurance coverage and obtaining necessary authorizations for patients requiring Continuous Glucose Monitoring (CGM) equipment. This role involves high-volume communication with insurance companies, patients, and healthcare providers to ensure seamless processing and approval of insurance claims.


Essential Duties and Responsibilities

Insurance Verification

o Verify patient insurance coverage and benefits for CGM equipment.

o Obtain pre-authorizations and pre-certifications as required by insurance providers.


Documentation

o Ensure all required documentation is complete and accurate for insurance claims submission.

o Maintain detailed records of insurance verification and authorization processes.


Communication

o Make 30+ outgoing calls per day to insurance companies, patients, and healthcare providers.

o Provide patients with updates regarding their insurance status and required documentation.


Administrative Duties

o Perform advanced administrative tasks including data entry and documentation follow-up.

o Supply regular productivity reports to management.


Collaboration

o Partner with team members to support related accounts and streamline verification processes.

o Work with e-prescribe and CRM platforms such as Brightree and Salesforce.


Other duties as assigned.

Requirements:

What'll You'll Bring

Ideal candidate has a basic knowledge of CGM equipment and DME (Durable Medical Equipment) sales processing. medical terminology, an energetic, optimistic demeanor, and a “can do/will do” attitude!

· Excellent verbal and written communication skills.

· Professional telephone etiquette and the ability to build relationships with patients and providers.

· Urgency, professionalism, and empathy in dealing with patients and busy medical professionals.

· Proficient in Microsoft Office and data entry.

· Experience with CRM platforms (Brightree, Salesforce) preferred.

· Attention to detail and accuracy in documentation.

· Ability to work independently with little supervision.

· High school diploma or medical vocational/technical school graduate equivalent.

· Previous experience in medical office settings or DME sales processing preferred.

· Experience in high-volume call activity and medical documentation chasing.



Why Quest Health Solutions, LLC

We recognize our people drive everything we accomplish, and as such, we are dedicated to investing in our employees by fostering a culture of continuous learning, growth, and excellence.

Our team works hard, and we recognize the importance of taking care of ourselves. We offer a comprehensive suite of benefit offerings to support the health, well-being, and financial health of our employees and their families. Our robust benefits package underscores our commitment to our people, our most important asset.

Quest Health Solutions seeks excellence through diversity in its staff. We prohibit discrimination based on race, color, religion, sex, age, national origin, sexual orientation, gender identity or expression, disability, veteran status, or marital status.


Benefits

· Medical, Dental, and Vision Insurance

· Life Insurance coverage

· Paid time off and Holiday Pay

· 401K with company match option

· Growth opportunities