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Insurance Claims Processing Jobs in Miami, FL (NOW HIRING)

Humana

Claims Processing Professional

Miramar, FL · On-site

$53K - $72K/yr

Knowledge of healthcare claims processing practices and medical insurance terminology. * Work across multiple computer systems. * Prioritize multiple tasks and work independently. * Commitment to ...

Humana

Claims Processing Professional

Miramar, FL · On-site

$53K - $72K/yr

Knowledge of healthcare claims processing practices and medical insurance terminology. * Work across multiple computer systems. * Prioritize multiple tasks and work independently. * Commitment to ...

Humana

Claims Processing Professional

Miramar, FL · On-site

$53K - $72K/yr

Knowledge of healthcare claims processing practices and medical insurance terminology. * Work across multiple computer systems. * Prioritize multiple tasks and work independently. * Commitment to ...

Humana, Inc.

Claims Processing Professional

Miramar, FL · On-site

$53K - $72K/yr

Knowledge of healthcare claims processing practices and medical insurance terminology. * Work across multiple computer systems. * Prioritize multiple tasks and work independently. * Commitment to ...

Independent Living Systems

Claims & Billing Analyst

Miami, FL · On-site

$45K - $61K/yr

Minimum of 2 years of experience in medical billing, claims processing, or revenue cycle management. * Strong knowledge of healthcare billing codes, insurance claim procedures, and payer guidelines.

Solis Health Plans

Claims Examiner

Doral, FL · On-site

$19 - $23/hr

Bachelor's degreepreferred Experience: * 2 years' experience with complex claims processing and/or auditing within the health insurance industry or medical healthcare deliverysystem * 2 years ...

Solis Health Plans

Claims Examiner

Doral, FL · On-site

$19 - $23/hr

Bachelor's degreepreferred Experience: * 2 years' experience with complex claims processing and/or auditing within the health insurance industry or medical healthcare deliverysystem * 2 years ...

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All JobsInsurance Claims Processing JobsInsurance Claims Processing Jobs in Miami, FL

Insurance Claims Processing information

See Miami, FL salary details

$11

$21

$32

How much do insurance claims processing jobs pay per hour?

As of Aug 28, 2026, the average hourly pay for insurance claims processing in Miami, FL is $21.36, according to ZipRecruiter salary data. Most workers in this role earn between $17.45 and $24.38 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 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 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.

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 or certifications in insurance or claims processing. Relevant skills include attention to detail, communication, and familiarity with claims management software. Gaining experience through internships or entry-level positions can improve job prospects, and some employers may require background checks or specific licensing depending on the state or company policies.

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 does an insurance claims processing do?

An insurance claims processor reviews and evaluates insurance claims to determine coverage and payout amounts. They verify policy details, gather necessary documentation, and ensure claims are processed accurately and efficiently, often using claims management software. Attention to detail and knowledge of insurance policies are essential for this role.

What are popular job titles related to Insurance Claims Processing jobs in Miami, FL?

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

What job categories do people searching Insurance Claims Processing jobs in Miami, FL look for?

The top searched job categories for Insurance Claims Processing jobs in Miami, FL are:

What cities near Miami, FL are hiring for Insurance Claims Processing jobs?

Cities near Miami, FL with the most Insurance Claims Processing job openings:

Insurance Claims Processing jobs near you
Infographic showing various Insurance Claims Processing job openings in Miami, FL as of August 2026, with employment types broken down into 1% As Needed, 74% Full Time, 20% Part Time, and 5% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $44,438 per year, or $21.4 per hour.

Claims Processing Professional

Humana

Miramar, FL • On-site

$53K - $72K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 13 days ago

Humana rating

8.0

Company rating: 8.0 out of 10

Based on 267 frontline employees who took The Breakroom Quiz

169th of 314 rated insurance

Job description

Become a part of our caring community
As a Claims Processing Professional, you'll review healthcare claims to help ensure their accuracy. You'll review claim information, verify eligibility, authorizations, and provider contracts, and determine appropriate claim outcomes while following established policies and regulatory guidelines.
In this in-office position reporting to the Enterprise Transformation Director, you'll collaborate with other teams, navigate multiple systems, and help deliver claim resolutions that support a positive experience for providers and members. If you enjoy making an impact behind the scenes, we'd love to have you on our team.This is in office position requires you to be on site at our Miramar, FL branch location.

As a Claims Processing Professional, you will:

  • Review and process healthcare claims within established turnaround times.
  • Verify member eligibility, provider information, authorizations, and contractual requirements before processing claims.
  • Determine whether you should approve, deny, adjust, or return claims for additional information.
  • Resolve claim discrepancies by gathering and evaluating supporting documentation.
  • Process both electronic and paper claims while maintaining productivity, quality, and accuracy standards.
  • Use multiple internal systems to review claims, document findings, and complete claim processing.
  • Maintain compliance with HIPAA regulations, organizational policies, and all applicable state and federal guidelines.
  • Collaborate with internal departments to resolve claim issues and support claim adjudication.
  • Adapt to evolving business processes, system enhancements and regulatory changes.
  • Meet productivity, quality, and performance expectations.

Use your skills to make an impact

Required Qualifications

  • Minimum of 1 year of healthcare claims processing experience.
  • Knowledge of healthcare claims processing practices and medical insurance terminology.
  • Work across multiple computer systems.
  • Prioritize multiple tasks and work independently.
  • Commitment to HIPAA compliance.

Preferred Qualifications

  • Experience processing medical, home health, or managed care claims.
  • Knowledge of CPT, ICD-10, and HCPCS coding.
  • Experience working with provider contracts, authorizations, or eligibility verification.
  • Bilingual (English/Spanish).
  • Associate's degree or higher in Business, Healthcare Administration, or a related field.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.


$53,700 - $72,600 per year


Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About Us
About OneHome: OneHome coordinates a full range of post-acute care ranging from home health, infusion therapy and durable medical equipment services at patients' homes. OneHome's patient focused model creates one integrated point of accountability that coordinates with physicians, hospitals and health plans serving more than one million health plan members nationwide. OneHome was acquired by Humana in 2021 to advance value-based care. Our culture is inclusive, diverse, and above all, caring. It is important to us that our employees are engaged, supported and fairly treated. We offer a comprehensive benefits package to ensure the health and financial well-being of you and your family.About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com.


Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

What Humana employees say

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About Humana

Sourced by ZipRecruiter

Humana Inc., headquartered in Louisville, KY., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Louisville, KY, US

Year founded

1961

Social media

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