Florida Auto PIP / Medical Payments Adjuster

Univista Holdings; Miami (FL); On-site; USD 45,000 - 65,000; Full time

Job summary

Univista Holdings is seeking a detail-oriented Florida Auto PIP / Medical Payments Adjuster in Miami, FL. This role is crucial for handling PIP and Medical Payments claims according to Florida regulations while ensuring quality service to insureds and medical providers.

The ideal candidate has experience with claims handling, reviews medical documentation accurately, and possesses strong communication skills. This position offers a competitive salary range of $45,000 to $65,000 annually.

Qualifications

• Some Florida PIP or Medical Payments claims handling experience.
• Some knowledge of Florida PIP statutes and fee schedules.
• Experience reviewing medical bills and medical documentation.

Responsibilities

• Review medical bills, records, and documentation for accuracy.
• Apply Florida PIP statutes and fee schedules to determine payments.
• Communicate with insureds, claimants, attorneys, and medical providers.
• Negotiate good‑faith settlements with providers.
• Document claim activity and maintain accurate files.
• Identify potential fraud indicators.

Skills

Florida PIP claims handling

Medical documentation review

Bilingual communication

Organizational skills

Tools

Claims system

Job description

Florida Auto PIP / Medical Payments Adjuster

Job Location: Miami, FL 33166

Salary Range: $45,000.00 - $65,000.00 per year

Florida Auto PIP / Medical Payments Adjuster

We are seeking a detail-oriented and experienced Florida Auto PIP / Medical Payments Adjuster to join our claims team. This position is responsible for handling Personal Injury Protection (PIP) and Medical Payments claims in accordance with Florida statutes, policy provisions, Medicaid and Medicare fee schedule and company guidelines. The ideal candidate will have strong knowledge of Florida PIP regulations, and the ability to manage claims efficiently while providing excellent service to insureds and medical providers.

Key Responsibilities

• Review medical bills, records, and documentation for accuracy and compliance
• Apply Florida PIP statutes and fee schedules to determine appropriate payments
• Communicate with insureds, claimants, attorneys, and medical providers
• Negotiate good‑faith settlements with provider offices
• Document claim activity and maintain accurate claim files
• Issue payments and explanations of benefits (EOBs) as appropriate
• Identify potential fraud indicators and escalate when necessary
• Maintain compliance with company procedures and regulatory requirements
• Manage claim workload to meet productivity and quality standards

Qualifications

• Some Florida PIP or Medical Payments claims handling experience
• Some knowledge of Florida PIP statutes and fee schedules
• Experience reviewing medical bills and medical documentation
• Excellent organizational and time management skills
• Strong bilingual written and verbal communication skills
• Ability to work independently and manage a high‑volume caseload
• Claims system experience preferred

Preferred Qualifications

• Florida Adjuster License (620 or equivalent)
• Experience with medical payments, Excel and/or medical coding