Top 41 Medical claims examiner Jobs in Florida

Claims Supervisor
SNI Companies —Tampa, FL
- $53,000 - $60,000 a year
- Inventory management
- HIPAA
- Mentoring
- Paid training
- Health savings account
Quick Apply
Injury Claims Examiner (East Region)
USAA —Tampa, FL
- $85,040 - $162,550 a year
- Hybrid work
- Background check
- Anatomy knowledge
- Military
- Paid holidays
- Health insurance
1d
Commercial Claims Adjuster - Remote
WAHVE —Jacksonville, FL
- Part-time
- Remote
- Senior level
- Commercial
- Health insurance
- 401(k)
10d
Claims - Examiner, Claims
Wellcove —Pensacola, FL
- Full-time
- Remote
- Background check
- Anatomy knowledge
- Basic math
Quick Apply
Examiner, Claims
Molina Healthcare —Florida
- $14.00 - $26.42 an hour
- Full-time
- Customer service
- Research
- Mid-level
- Health insurance
Claims - Claims Examiner
Wellcove —Pensacola, FL
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Customer service
Quick Apply
Senior Examiner, Claims
Molina Healthcare —Florida
- $14.90 - $29.06 an hour
- Full-time
- Customer service
- Research
- Mid-level
- Health insurance
Claims Examiner
Allcat Claims Service —Florida
- Overtime
- Remote
- Microsoft Excel
- Microsoft Outlook
- Customer service
- Paid holidays
- Health insurance
MEDICAL DISABILITY EXAMINER - 64083941
The State of Florida —Tampa, FL
- $41,739.88 - $78,418.23 a year
- Weekends as needed
- Background check
- Basic math
- Pass drug screening
- Paid holidays
- Disability insurance
7d
Claims Examiner
Heritage Insurance —Sunrise, FL
- Overtime
- Background check
- Research
- Mid-level
Quick Apply
Claims Examiner - Workers Compensation | Dedicated Account | Jurisdiction/Licensing: FL - Required (Remote)
Sedgwick —Florida
- Full-time
- Remote
- 5 years
- High school diploma or GED
- Bachelor's degree
- Health insurance
- Dental insurance
MEDICAL DISABILITY EXAMINER - 64004787
The State of Florida —Jacksonville, FL
- $41,738.88 - $78,418.23 a year
- Weekends as needed
- Background check
- Basic math
- Pass drug screening
- Paid holidays
- Disability insurance
9d
Claims Examiner, Credit
Fortegra —Jacksonville, FL
- On call
- HIPAA
- Mid-level
- High school diploma or GED
- Disability insurance
- Health insurance
Quick Apply
MEDICAL DISABILITY EXAMINER - 64083724
The State of Florida —Orlando, FL
- $41,739.88 - $78,418.23 a year
- Weekends as needed
- Background check
- Basic math
- Pass drug screening
- Paid holidays
- Disability insurance
12h
Claim Examiner- Liability
Broadspire Services, Inc. —Tampa, FL
- Full-time
- Remote
- Mid-level
- Analysis skills
- Bachelor's degree
- Paid parental leave
- Health savings account
Quick Apply
3d
MEDICAL DISABILITY EXAMINER - 64083671
The State of Florida —Miami, FL
- $41,739.88 - $78,418.23 a year
- Weekends as needed
- Background check
- Basic math
- Pass drug screening
- Paid holidays
- Disability insurance
9d
Surety Claims Examiner
Guardian Group —Florida
- Construction site
- Mid-level
- Residential
- Travel reimbursement
- Profit sharing
Claims Examiner
Markel Service Inc. —Tampa, FL
- $62,000 - $85,800 a year
- Email
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- AD&D insurance
- Employee stock purchase plan
Quick Apply
9d
OPS RECORDS ANALYST - 64858477
The State of Florida —Miami, FL
- $20.25 an hour
- Temporary
- Background check
- Medical office experience
- Pass drug screening
- Dental insurance
- Flexible spending account
2d
Claims - Team Lead
Wellcove —Pensacola, FL
- Full-time
- Remote
- Basic math
- Mid-level
- Conflict management
Quick Apply

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Claims Supervisor

SNI Companies -
Tampa, FL

Quick Apply

Job Details

$53,000 - $60,000 a year

Benefits

Paid training
Health savings account
Paid holidays
Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance

Qualifications

Performance dashboard reports
Data visualization software proficiency
Production data analysis
Healthcare staff management
Business intelligence report generation
Managing production or assembly teams
Metrics Reporting
Business intelligence tools
Leading team collaboration initiatives
Managing insurance claims teams
Healthcare performance metrics analysis
Healthcare data reporting

Full Job Description

Position Summary
The Healthcare Claims Supervisor is responsible for the overall operational performance, client satisfaction, KPI achievement, reporting oversight, and leadership of assigned healthcare claims accounts. This role oversees Team Leads and Claims Examiners while serving as a key liaison between clients and internal departments including Operations, Quality, Training, Workforce Management, and Account Management.

The Supervisor is accountable for ensuring production, quality, turnaround time, attendance, compliance, and service-level expectations are consistently achieved. This individual must be highly organized, data-driven, proactive, and capable of managing both operational execution and client relationships in a fast-paced environment.

Success in this role requires the ability to identify operational risks early, drive corrective actions, maintain strong client confidence, and foster a culture of accountability, performance, and continuous improvement.

Key Responsibilities
Operational Leadership & Accountability

Oversee daily claims operations across assigned accounts and lines of business.
Ensure achievement of all client KPIs, SLAs, quality standards, and operational deliverables.
Monitor productivity, inventory, aging, turnaround times, workflow distribution, attendance, and backlog risks.
Develop and execute action plans to address performance gaps and operational challenges.
Partner with Workforce Management and Operations Leadership on staffing, forecasting, and capacity planning.
Support implementations, transitions, and account expansions to ensure operational readiness.
Successfully complete training and demonstrate proficiency in assigned claims processes.

Performance & KPI Management

Maintain ownership of account-level operational metrics and performance outcomes.
Analyze trends related to productivity, quality, error rates, SLA compliance, attendance, inventory aging, and client escalations.
Hold Team Leads and staff accountable through coaching, performance reviews, corrective actions, and performance improvement plans.
Drive a culture of urgency, accountability, and continuous improvement.
Ensure timely resolution of performance issues and consistent execution of operational expectations.

Client Management & Client Satisfaction

Serve as a primary operational contact for assigned client accounts.
Participate in weekly, monthly, and quarterly business reviews, client meetings, calibrations, and operational discussions.
Build strong client relationships through proactive communication and consistent operational performance.
Manage client concerns and escalations with clear ownership, timely follow-through, and effective resolution.
Collaborate with Account Management and Leadership to support client satisfaction, retention, and growth.

Reporting & Metrics Management

Prepare, analyze, and present operational reports, dashboards, and performance metrics.
Deliver accurate and timely reporting to clients and internal leadership.
Identify trends, risks, and opportunities through data analysis and recommend actionable solutions.
Utilize Excel, Power BI, client systems, and operational reporting tools to monitor account performance.
Present performance results, improvement initiatives, and operational recommendations professionally and effectively.

Quality, Compliance & Process Improvement

Ensure compliance with client requirements, HIPAA regulations, CMS guidelines, and company policies.
Partner with Quality Assurance teams on calibrations, audits, error trend analysis, and remediation efforts.
Conduct root cause analysis and implement corrective actions to improve quality and efficiency.
Support audit readiness, compliance initiatives, and process improvement programs.

Team Leadership & Development

Coach, mentor, and develop Team Leads and Claims Examiners.
Support onboarding, nesting, cross-training, and ongoing employee development.
Reinforce leadership accountability and operational excellence.
Promote employee engagement, retention, succession planning, and professional growth.
Foster a culture of teamwork, ownership, professionalism, and high performance.

Key Performance Indicators (KPIs)

Production Goal Achievement
SLA Compliance
Quality Scores (Target: 98%–100%)
Inventory & Aging Management
Attendance & Adherence
Client Satisfaction
Escalation Resolution Timeliness
Reporting Accuracy & Timeliness
Reduction of Repeat Errors
Employee Retention & Engagement
Coaching and Performance Documentation Compliance

Qualifications

Minimum 3–5 years of Medicare Advantage and/or MediCal healthcare claims leadership and hands on experience.
Prior supervisory experience overseeing production teams required.
Strong experience managing healthcare payer operations and claims workflows.
Experience with client-facing operations and client relationship management.
Strong reporting and data analysis experience required.
Experience owning operational KPIs and performance deliverables.
Strong leadership, accountability, organizational, and communication skills.
Experience with systems such as EZ-CAP, QNXT, Facets, Jiva, Plexis, or similar preferred.
Intermediate to advanced Excel and reporting/dashboard experience required.
Experience managing offshore and/or remote teams preferred.

Salary $53,000-$60,000

What We Offer

Remote work offered
Equipment provided
Paid training to set you up for success
Comprehensive benefits: Medical, Dental, Vision, Life, HSA, 401(k)
Paid Time Off (PTO)
7 paid holidays
A supportive team and a company that values internal growth

#ACCTN

Quick Apply

Refine Your Search

medical claims examiner jobs in florida

Claims Supervisor

Injury Claims Examiner (East Region)

Commercial Claims Adjuster - Remote

Claims - Examiner, Claims

Examiner, Claims

Claims - Claims Examiner

Senior Examiner, Claims

Claims Examiner

MEDICAL DISABILITY EXAMINER - 64083941

Claims Examiner

Claims Examiner - Workers Compensation | Dedicated Account | Jurisdiction/Licensing: FL - Required (Remote)

MEDICAL DISABILITY EXAMINER - 64004787

Claims Examiner, Credit

MEDICAL DISABILITY EXAMINER - 64083724

Claim Examiner- Liability

MEDICAL DISABILITY EXAMINER - 64083671

Surety Claims Examiner

Claims Examiner

OPS RECORDS ANALYST - 64858477

Claims - Team Lead

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