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Medicaid Claims Processing Jobs in Florida (NOW HIRING)

1 Legacy, Inc

Manager I Claims

Miami, FL · On-site

Assure timely and accurate processing of Medicare claims and encounters, and respond to provider ... Minimum of 5 years of Medicare/Medicaid claims experience that demonstrates progressive growth ...

Wellcove

Claims - Claims Examiner

Pensacola, FL · On-site

Apply knowledge of Coordination of Benefits (COB), Medicare, Medicaid, and other payer sources when applicable * Ensure claims are processed within established turnaround times and service level ...

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 ... Experience working with Medicare, Medicaid, and private insurance claims. * Familiarity with health ...

Solis Health Plans

Claim Examiner I

Miami, FL · On-site

$19 - $23/hr

Review, analyze, and process medical claims in accordance with Medicare and DSNP benefit structures ... Ensure compliance with CMS (Centers for Medicare & Medicaid Services), state regulations, and ...

Solis Health Plans

Claim Examiner I

Miami, FL · On-site

$19 - $23/hr

Review, analyze, and process medical claims in accordance with Medicare and DSNP benefit structures ... Ensure compliance with CMS (Centers for Medicare & Medicaid Services), state regulations, and ...

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Medicaid Claims Processing information

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How much do medicaid claims processing jobs pay per hour?

As of Aug 12, 2026, the average hourly pay for medicaid claims processing in Florida is $14.32, according to ZipRecruiter salary data. Most workers in this role earn between $12.21 and $15.43 per hour, depending on experience, location, and employer.

What is a Medicaid claims processing job?

A Medicaid Claims Processing job involves reviewing, verifying, and processing healthcare claims submitted by providers seeking reimbursement for services rendered to Medicaid beneficiaries. Workers in this role ensure claims comply with state and federal regulations, identify errors or discrepancies, and communicate with healthcare providers to resolve issues. They may also use specialized software to input and track claims, process denials or appeals, and ensure timely and accurate payments. Strong attention to detail, knowledge of Medicaid policies, and proficiency with healthcare billing codes are essential for success in this role.

How to get a job as a Medicaid Claims Processing specialist?

To become a Medicaid Claims Processing specialist, candidates typically need a high school diploma or equivalent, with some roles requiring an associate degree or relevant certification. Experience with healthcare billing, claims processing software, and knowledge of Medicaid policies are important; familiarity with tools like claims management systems can improve job prospects. Applying through healthcare organizations, government agencies, or staffing agencies and demonstrating attention to detail and knowledge of healthcare regulations are key steps.

Is a Medicaid Claims Processing job in demand?

Medicaid Claims Processing jobs are in demand due to the ongoing need for healthcare administration and insurance claims management. These roles often require attention to detail and familiarity with claims processing software, and employment opportunities are expected to grow with the expansion of healthcare programs.

What are some typical challenges faced in Medicaid claims processing, and how can I prepare for them?

One of the main challenges in Medicaid Claims Processing is staying up-to-date with frequently changing policies, billing codes, and compliance requirements, which can vary by state and program. Professionals in this role must pay close attention to detail to avoid errors and denials, often working with tight deadlines and large volumes of claims. To prepare, it's helpful to become familiar with Medicaid guidelines, maintain strong organizational habits, and proactively seek out updates in regulations or coding standards. Collaborating with other team members, such as care coordinators and billing specialists, is essential to ensure claims are accurate and properly documented. Ongoing learning and adaptability are key for long-term success in this dynamic environment.

What are the key skills and qualifications needed to thrive in Medicaid claims processing?

Success in Medicaid Claims Processing requires excellent attention to detail, a thorough understanding of healthcare billing procedures, and familiarity with Medicaid regulations and insurance guidelines. Proficiency in medical billing software, claims management systems, and sometimes industry certifications such as Certified Professional Coder (CPC) is beneficial. Strong organizational skills, problem-solving abilities, and effective written and verbal communication help individuals excel in this role. These skills and qualifications are crucial for ensuring accurate, timely claims processing and compliance with ever-evolving Medicaid requirements.

Is Medicaid claims processing a stressful job?

Medicaid claims processing can be stressful due to the high volume of claims, strict deadlines, and the need for accuracy to prevent errors. Employees often work with detailed data and may experience pressure during busy periods or when resolving complex issues, but proper training and workflow management can help mitigate stress.
What are the most commonly searched types of Medicaid Claims Processing jobs in Florida? The most popular types of Medicaid Claims Processing jobs in Florida are:
What are popular job titles related to Medicaid Claims Processing jobs in Florida? For Medicaid Claims Processing jobs in Florida, the most frequently searched job titles are:
What job categories do people searching Medicaid Claims Processing jobs in Florida look for? The top searched job categories for Medicaid Claims Processing jobs in Florida are:
Medicaid Claims Processing jobs near you
Infographic showing various Medicaid Claims Processing job openings in Florida as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $29,790 per year, or $14.3 per hour.

Manager I Claims

1 Legacy, Inc

Miami, FL • On-site

Full-time

Re-posted 29 days ago

Job description

Company Description

Finance / Accounting - Claims Review and Adjusting

Healthcare / Health Services

Job Description

Responsibilities in this senior position will include, but are not limited to:
Responsible for directing the planning, design, development, implementation and evaluation of policies and procedures that assure accurate, timely claims and encounter processing and provider inquiries (written or verbal).
Assure timely and accurate processing of Medicare claims and encounters, and respond to provider telephone calls, written inquiries, and appeals.
The compilation of all information and documents required for claims and encounter processing and related inquiries to assure compliance with all applicable rules, regulations, and external and internal policies and procedures
The review of provider contracts and configuration of these contracts within the claims processing system to assure accurate payments to our providers
Collaboration and communication with other SHP departments on claims and encounter issues, related projects and inter-departmental operations issues
Development and maintenance of well-defined processes to enter, adjust, manage and report claims and encounters data
Preparation and timely submission of management and regulatory reports
Generation of configuration requests to assure accurate, timely administration of providers claims and processing and reporting of encounters
Maintain a full comprehensive understanding of the covered benefits, coding and reimbursement policies and contracts
Production and submission of reports as required
Analyze, track and trend claims and encounters data; identify any potential service or systems issues;implement interventions and determine success of interventions

Qualifications

Requirements:
BA/BS degree preferred with at least 5 years of relevant professional experience, and the following OR any combination of education and experience which would provide an equivalent background:
Minimum of 2 years of managerial experience at the department manager level preferred.
Minimum of 5 years of Medicare/Medicaid claims experience that demonstrates progressive growth within claims operations.
Extensive knowledge of claims policies and procedures, including industry standards from Medicaid, CMS, and CCI Edits.
Excellent oral and writing skills.
Highly developed quantitative and qualitative analytical skills.
Highly developed project management skills.

Additional Information

All your information will be kept confidential according to EEO guidelines.

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