Entry-Level Claims Settlement Associate | AI-Driven

Zelis Healthcare, LLC; Saint Petersburg (FL); Hybrid; USD 40,000 - 60,000; Full time

Job summary

Zelis is hiring an entry-level claims associate in Florida to handle and negotiate settlements with policyholders, claimants, and third parties. You will evaluate claims, determine liability, and propose fair settlements in line with company policies.

You should have strong communication skills, meticulous attention to detail, and a basic understanding of claims processes. The role supports our hybrid, office-and-field approach and offers growth in a dynamic healthcare finance company.

Qualifications

• Entry-level claims settlement role requiring basic understanding of claims processes.
• Strong communication skills and attention to detail.
• Willingness to attend training and local meetings.
• Must comply with company policies and regulatory requirements.

Responsibilities

• Review and analyze simple claims to determine coverage, liability, and damages.
• Gather and assess documentation including medical records and reports.
• Conduct initial investigations to verify claim validity.
• Negotiate fair and timely settlements with policyholders and third parties.
• Document negotiations and settlements in the claims system.
• Provide excellent customer service and address inquiries promptly.
• Educate claimants on the claims process and their rights.
• Maintain accurate records of all claim activities.
• Prepare reports and summaries of claims for management.

Skills

Communication

Negotiation

AI tooling

MS Office

Claims software

Insurance knowledge

Education

BA or equivalent

Tools

Microsoft Office Suite

Claims management software

Job description

Zelis is hiring an entry-level claims associate in Florida to handle and negotiate settlements with policyholders, claimants, and third parties. You will evaluate claims, determine liability, and propose fair settlements in line with company policies.

You should have strong communication skills, meticulous attention to detail, and a basic understanding of claims processes. The role supports our hybrid, office-and-field approach and offers growth in a dynamic healthcare finance company.