Insurance Claims Specialist

UF Health; Jacksonville (FL); Hybrid; USD 52,000 - 70,000; Full time

Job summary

UF Health Jacksonville is seeking an Insurance Claims Specialist to support the revenue cycle by managing and evaluating insurance claims for accuracy and timely processing.

The role requires investigating claims, negotiating settlements per policy guidelines, and responding to inquiries from claimants and providers. The position emphasizes accurate submission, collaboration with internal teams, and maintaining audit-ready records.

Qualifications

• 2+ years of experience in insurance claims processing or related support.
• Working knowledge of insurance policies, coverage, and claim adjudication processes.
• Experience investigating, resolving, and following up on claim issues.
• Strong communication and customer service skills.
• Ability to maintain detailed records and ensure compliance.

Responsibilities

• Manage and evaluate insurance claims to ensure accuracy and timely processing
• Investigate claims and negotiate settlements in accordance with policy guidelines
• Respond to inquiries from claimants and other related parties in a timely and professional manner
• Assist clients with accurate and complete claim submission
• Coordinate with internal teams to facilitate efficient claim resolution
• Maintain detailed records and ensure compliance with audit standards and regulatory requirements

Skills

Strong communication

Customer service

Education

High school diploma or equivalent

Job description

Overview

Insurance Claims Specialist

Work Style: Hybrid

Location Requirement: UF Health Jacksonville

FTE: Full-Time (1.0 FTE)

Manages and evaluates insurance claims to ensure accurate coverage determination and timely processing. Investigates claims, reviews documentation, and responds to inquiries from claimants, providers, and payers.

Assists clients in submitting claims correctly and collaborates with internal teams to support efficient resolution. Maintains detailed records, verifies compliance with regulatory and organizational standards, and supports audit readiness.

Plays a key role in optimizing cash application processes, resolving discrepancies, and improving overall revenue cycle performance.

Responsibilities

Key Responsibilities:

• Manage and evaluate insurance claims to ensure accuracy and timely processing
• Investigate claims and negotiate settlements in accordance with policy guidelines
• Respond to inquiries from claimants and other related parties in a timely and professional manner
• Assist clients with accurate and complete claim submission
• Coordinate with internal teams to facilitate efficient claim resolution
• Maintain detailed records and ensure compliance with audit standards and regulatory requirements

Qualifications

Minimum Qualifications

• High school diploma or equivalent required
• 2+ years of experience in insurance claims processing or related support
• Working knowledge of insurance policies, coverage, and claim adjudication processes
• Experience investigating, resolving, and following up on claim issues
• Strong communication and customer service skills
• Ability to maintain detailed records and ensure compliance