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Medical Insurance Analyst Jobs in Florida (NOW HIRING)

CES, LLC

Medical Review Nurse III

Saint Augustine, FL · Remote

Utilize extensive knowledge of medical terminology, ICD-9-CM and ICD-10-CM, HCPCS Level II and CPT coding along with analysis and processing of Medicare claims. Utilize Medicare and Contractor ...

Kubicki Draper

Insurance Coverage Attorney

Miami, FL · On-site

Insurance coverage analysis. * Communicate in a highly effective manner with team members and ... Benefits We offer competitive pay, top-tier medical insurance, 401(k) with matching, and much more.

Kubicki Draper

Insurance Coverage Attorney

Miami, FL · Hybrid

Insurance coverage analysis. * Communicate in a highly effective manner with team members and ... Benefits We offer competitive pay, top-tier medical insurance, 401(k) with matching, and much more.

Kubicki Draper

Insurance Coverage Attorney

Miami, FL · On-site

Insurance coverage analysis. * Communicate in a highly effective manner with team members and ... Benefits We offer competitive pay, top-tier medical insurance, 401(k) with matching, and much more.

Collabera LLC

Associate Data Analyst

Orlando, FL · On-site

$22 - $24/hr

Associate Data Analyst Campus / New Graduate Industry: Global Professional Services / Accounting ... medical insurance, dental insurance, vision insurance, 401(k) retirement plan, life insurance ...

Revenue Management Solutions

Analyst

Tampa, FL · On-site

Description THE OPPORTUNITY As an Analyst, you will provide critical support to our North America ... As a full-time RMS employee, you will receive: * 100% employer paid HSA medical insurance, or 80 ...

Revenue Management Solutions

Analyst

Tampa, FL · On-site

Description THE OPPORTUNITY As an Analyst, you will provide critical support to our North America ... As a full-time RMS employee, you will receive: * 100% employer paid HSA medical insurance, or 80 ...

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All JobsMedical Insurance Analyst JobsMedical Insurance Analyst Jobs in Florida

Medical Insurance Analyst information

What does a medical insurance analyst do?

A Medical Insurance Analyst is responsible for reviewing and processing medical insurance claims to ensure accuracy and compliance with policy guidelines. They analyze patient records, verify coverage, and determine the eligibility of claims for payment. Additionally, they communicate with healthcare providers, patients, and insurers to resolve discrepancies or obtain additional information. Their work helps prevent fraudulent claims and ensures that providers and patients receive timely reimbursement.

What are the key skills and qualifications needed to thrive as a medical insurance analyst?

To thrive as a Medical Insurance Analyst, you need a solid understanding of healthcare billing, coding procedures (such as ICD-10 and CPT), and insurance policy analysis, often supported by a relevant degree or certification in health information management. Familiarity with claims management software, electronic health records (EHRs), and regulatory compliance tools is typically required. Attention to detail, analytical thinking, and strong communication skills make candidates stand out in this position. These competencies are crucial for accurately processing claims, preventing errors or fraud, and ensuring effective coordination between healthcare providers and insurers.

How does a medical insurance analyst typically collaborate with healthcare providers and insurance companies?

Medical Insurance Analysts frequently act as a liaison between healthcare providers and insurance companies to ensure accurate claims processing and resolution of discrepancies. They review medical documentation, interpret insurance policies, and communicate with both parties to clarify information or resolve billing issues. This collaboration often involves regular meetings, phone calls, and written correspondence to ensure compliance with regulations and timely reimbursement. Effective teamwork and clear communication are essential in this role to facilitate smooth claim approvals and maintain strong professional relationships.

How much does a medical insurance analyst make?

The average salary for a medical insurance analyst typically ranges from $50,000 to $75,000 per year, depending on experience, location, and certifications. Entry-level positions may start lower, while experienced analysts with specialized skills can earn higher salaries. Many roles also include benefits such as health insurance and professional development opportunities.

What degree do I need to be a medical insurance analyst?

A medical insurance analyst typically needs at least a bachelor's degree in health administration, health informatics, finance, or a related field. Relevant skills include knowledge of healthcare policies, data analysis, and familiarity with insurance billing systems; certifications such as CPC or HCISPP can also enhance job prospects.

What is the role of a medical insurance analyst?

A medical insurance analyst reviews and evaluates insurance claims, policies, and coverage details to ensure accuracy and compliance. They analyze data to identify trends, assist with claims processing, and support the development of insurance policies, often using specialized software and requiring knowledge of healthcare regulations.

What are popular job titles related to Medical Insurance Analyst jobs in Florida?

For Medical Insurance Analyst jobs in Florida, the most frequently searched job titles are:

What job categories do people searching Medical Insurance Analyst jobs in Florida look for?

The top searched job categories for Medical Insurance Analyst jobs in Florida are:

What cities in Florida are hiring for Medical Insurance Analyst jobs?

Cities in Florida with the most Medical Insurance Analyst job openings:

Medical Insurance Analyst jobs near you
Infographic showing various Medical Insurance Analyst job openings in Florida as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 12% Part Time, and 5% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution.

Medical Review Nurse III

CES, LLC

Saint Augustine, FL • Remote

Full-time

Posted 9 days ago

Key responsibilities

  • Review medical records and claims data to determine if they meet Medicare and Medicaid guidelines.

  • Coordinate and compile written Investigative Summary Reports upon completion of records review.

  • Work with healthcare professionals, regulatory agencies, and law enforcement to support fraud investigations and program integrity efforts.

Job description

Job Description Summary: 
The Medical Reviewer will utilize Medicare and/or Medicaid rules, regulations, and guidelines in reviewing medical records documentation to determine if a claim meets these requirements. Primarily responsible for conducting clinical reviews of medical records during the course of fraud investigations or other program integrity initiatives such as requests for information or in support of proactive data analysis efforts. Applies Medicare guidelines in making clinical determinations as to the appropriateness of payment coverage. The Medical Reviewer coordinates and compiles the written Investigative Summary Report to the Program Integrity Investigator upon completion of the records review within timelines set by CMS. 
 
Duties/Responsibilities:   
  • Review information contained in Standard Claims Processing System files (e.g., claims history, provider files) to determine provider billing patterns and to detect potentially fraudulent or abusive billing practices or vulnerabilities in Medicare payment policies 
  • Utilize extensive knowledge of medical terminology, ICD-9-CM and ICD-10-CM, HCPCS Level II and CPT coding along with analysis and processing of Medicare claims.  Utilize Medicare and Contractor guidelines for coverage determination 
  • Coordinate and compile written Investigative Summary Reports in conjunction with PI Investigators upon completion of the records review 
  • Uses leadership and communication skill to work with physicians and other health professionals as well as external regulatory agencies and law enforcement personnel 
  • Provide training to staff on medical terminology, reading medical records, and policy interpretation 
  • Provide expert witness testimony as required 
  • Complete assignments in a manner that meets or exceeds the quality assurance goal of 98% accuracy 
  • Maintain chain of custody on all documents and follows all confidentiality and security guidelines 
  • Perform other duties as assigned by the Medical Review Supervisor that contribute to goals and objectives and comply with the Program Integrity Manual and Statement of Work guidelines and CMS directives and regulations 
 
Required qualifications/skills: 
  • Graduate from an accredited school of nursing and has an active license as a Registered Nurse (RN).  
  • Knowledge of, and the ability to correctly identify, Medicare coverage guidelines 
  • Excellent oral and written communication skills 
  • Proficient with Microsoft Word, Excel and Internet applications 
  • Ability to efficiently organize and manage workload and assignments 
  • A minimum of 4 years of utilization/quality assurance review and ICD-9/10-CM/CPT-4 coding experience 
  • At least 4 years' experience in coding and abstracting, working knowledge of Diagnosis Related Groups (DRGs), Prospective Payment Systems, and Medicare coverage guidelines is required 
  • Advanced knowledge of medical terminology and experience in the analysis and processing of Medicare claims, utilization review/quality assurance procedures, ICD-9/10-CM and CPT-4 coding, Medicare coverage guidelines, and payment methodologies (i.e., Correct Coding Initiative, DRGs, Prospective Payment Systems, and Ambulatory Surgical Center), NCPDP and other types of prescription drug claims is required 
  • Ability to read Medicare claims, both paper and electronic, and a basic knowledge of the Medicare claims systems is required 
 
Preferred qualifications/skills: 
  • None  
 
Other: 
  • Must have and maintain a valid driver's license for the associate's state of residence  
  • Travel may be required as necessary, with prior approval. All necessary travel expenses are reimbursable via GSA standards 
  • Must have no adverse actions pending or taken against him/her by any State or Federal licensing board or program; and must have no conflict of interest (COI) as defined in § 1154(b)(1) of the Social Security Act. 
 
Supervisory Responsibilities: 
  • None 
 
Office Equipment (if a WFH position): 
  • A locking cabinet and/or desk appropriate for storing documents and electronic media 
  • A cross-cut or micro-cut (preferred) shredder. 
  • Broadband internet connection  
  • Phone line (land line or cellular)  
 
Physical Requirements: 
  • May require prolonged periods of sitting at a desk, working on a computer and conducting phone interviews