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Senior Claims Quality Analyst Jobs in Boca Raton, FL

HUB

Senior Claims Consultant

Davie, FL

Strong community support and involvement through HUB Gives SUMMARY The Senior Claims Consultant ... Strong analytical skills with the ability toidentifycoverage arguments, policy ambiguities, and ...

ChenMed

Senior Health Economics Analyst

Miami, FL · On-site

$76K - $109K/yr

The Senior Health Economics Analyst is responsible for identifying and delivering data-driven ... Analyzes and interpret enrollment, revenue, and claims (utilization and unit cost) data to identify ...

Moss

Claims Manager

Fort Lauderdale, FL · On-site

Moss prides itself on a strong entrepreneurial culture that honors safety, quality, client ... SENIOR DIRECTOR, CLAIMS Moss is an equal opportunity employer. We celebrate diversity and are ...

Moss

Claims Manager

Fort Lauderdale, FL · On-site

Moss prides itself on a strong entrepreneurial culture that honors safety, quality, client ... SENIOR DIRECTOR, CLAIMS Moss is an equal opportunity employer. We celebrate diversity and are ...

Moss

Claims Manager

Fort Lauderdale, FL · On-site

Moss prides itself on a strong entrepreneurial culture that honors safety, quality, client ... SENIOR DIRECTOR, CLAIMS Moss is an equal opportunity employer. We celebrate diversity and are ...

Ubicquia

Quality Assurance Analyst

Fort Lauderdale, FL · On-site

Senior Quality Assurance Test Engineer Job Type : Full-time Department: Software Reports To: VP of ... Statistical Analysis: Apply statistical methods, including items such as Design of Experiments ...

ChenMed, LLC

Senior Health Economics Analyst

Miami, FL · On-site

$76K - $109K/yr

The Senior Health Economics Analyst is responsible for identifying and delivering data-driven ... Analyzes and interpret enrollment, revenue, and claims (utilization and unit cost) data to identify ...

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Senior Claims Quality Analyst information

See Boca Raton, FL salary details

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$46

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How much do senior claims quality analyst jobs pay per hour?

As of Aug 31, 2026, the average hourly pay for senior claims quality analyst in Boca Raton, FL is $46.42, according to ZipRecruiter salary data. Most workers in this role earn between $33.99 and $50.62 per hour, depending on experience, location, and employer.

What is a senior claims quality analyst?

Senior Claims Quality Analysts are experienced professionals who evaluate and ensure the accuracy, consistency, and compliance of insurance claims processing. They review claims files, audit claim decisions, and identify trends or errors to improve the overall quality of claims handling. In addition, they may develop training materials, work with claims teams to implement best practices, and report findings to management to help enhance operational efficiency and customer satisfaction.

What are the key skills and qualifications needed to thrive as a senior claims quality analyst?

To thrive as a Senior Claims Quality Analyst, you need expertise in claims processing, quality assurance methodologies, and a thorough understanding of insurance regulations, typically supported by a bachelor's degree and experience in claims management. Familiarity with claims management systems, auditing tools, and data analysis software such as Excel or SAS is commonly required. Attention to detail, analytical thinking, and strong communication skills help professionals identify errors and drive process improvements. These skills ensure the accuracy, compliance, and efficiency of claims operations, safeguarding both the organization and its clients.

What are some typical challenges faced by senior claims quality analysts and how can they be addressed?

Senior Claims Quality Analysts often encounter challenges such as identifying process inefficiencies, ensuring compliance with regulatory standards, and balancing the need for thorough analysis with timely claim processing. Effective communication and collaboration with claims adjusters and other stakeholders are vital to address discrepancies and implement process improvements. Staying updated on industry regulations and leveraging quality assurance tools can also help manage these challenges and maintain high standards.

What is the difference between Senior Claims Quality Analyst vs Claims Quality Analyst?

AspectSenior Claims Quality AnalystClaims Quality Analyst
Required CredentialsBachelor's degree, certifications like CPCU or ASQBachelor's degree often preferred, certifications optional
Work EnvironmentInsurance companies, third-party administratorsInsurance companies, claims departments
Employer & Industry UsageCommonly used in larger organizations for quality oversightEntry to mid-level roles in claims processing

The Senior Claims Quality Analyst typically has more experience, advanced certifications, and responsibilities overseeing quality assurance processes. The Claims Quality Analyst focuses on processing claims accurately and ensuring quality at an operational level. Both roles are essential in insurance claims departments but differ mainly in seniority and scope of responsibilities.

Is a senior claims quality analyst a good career?

A senior claims quality analyst is a valuable role in the insurance industry, focusing on reviewing and improving claims processes to ensure accuracy and compliance. It often requires strong analytical skills, attention to detail, and knowledge of claims management systems, making it a stable career with opportunities for advancement. The role can lead to positions in management or specialized areas within insurance companies.

What does a senior claims quality analyst do?

A senior claims quality analyst reviews insurance claims to ensure accuracy, compliance, and adherence to company policies. They analyze claim data, identify errors or inconsistencies, and recommend process improvements, often using quality assurance tools and metrics. This role requires strong attention to detail, knowledge of claims processing, and experience with auditing procedures.

What cities near Boca Raton, FL are hiring for Senior Claims Quality Analyst jobs?

Cities near Boca Raton, FL with the most Senior Claims Quality Analyst job openings:

Senior Claims Quality Analyst jobs near you

Senior Claims Auditor

Seminole Tribe of Florida

Hollywood, FL • On-site

Full-time

Medical

Re-posted 10 days ago

Job description

Position: Senior Claims Auditor
Job Type: Full Time
Department: Health & Human Services
Location: HOLLYWOOD
Posted: 02/23/2026
Job Description
The incumbent in this position is responsible for being the team lead in auditing and reviewing Tribal benefit activities and processing health claims, including analyzing payments, procedures and guidelines of benefits. The individual investigates the validity of claims, reviews and settles benefit claims and processes claims for payment ensuring that Tribal Member's health insurance claims are processed and resolved in a timely manner. The individual provides assistance and guidance to the Health Plan Program Manager, Health Plan team, Health & Human Services Leadership, Tribal Members and other relating employees on health insurance claims. The incumbent maintains accurate case files and issues reports on general claims activity. Bachelor's degree in Health Administration, Accounting, Business Administration, Human Resources Management or related field is required. A minimum of three (5) years of experience working as team lead, supervisor, claims auditor, benefits coordinator or experience processing insurance claims is required with at least two (2) years of experience as a Certified Professional Coder (CPC), is required. An equivalent combination of education/training and experience will be considered. Possession of a valid Florida Driver's License is required. Demonstrate excellent customer service and organizational skills. Demonstrate excellent written and verbal communication skills. Demonstrate proficiency utilizing Microsoft software packages. Ability to work a flexible schedule including evenings, weekends and holidays.
Benefits:
The Seminole Tribe of Florida provides a comprehensive benefits package.
The Seminole Tribe of Florida is a drug free workplace, drug screening is a requirement of employment. We exercise Native American preference.

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