Insurance Claims Specialist

UF Health; St. Augustine South (FL); Hybrid; USD 42,000 - 70,000; Full time

Benefits offered by this job

Hybrid work model

Job summary

UF Health Flagler is seeking an Insurance Claims Specialist to join our revenue cycle team in a hybrid role. You will manage and evaluate insurance claims for accurate coverage and timely processing, investigate discrepancies, and support claim submissions from clients and providers.

This role requires 2+ years in claims processing, strong communication, attention to detail, and compliance with regulatory standards.

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

Communication

Customer service

Attention to detail

Record keeping

Auditing

Education

High school diploma or equivalent

Job description

Overview

Insurance Claims Specialist

Work Style: Hybrid

Location Requirement: UF Health Flagler

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