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UF Health

Insurance Claims Specialist

Career Insights for Claims Adjuster / Specialist (General)

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Based on Florida data

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What they do

A Claims Adjuster or Specialist investigates and evaluates insurance claims. Specializes in a particular type of insurance. Inspects property damage, including damage to homes, buildings and cars; reviews claims after they are submitted; may authorize or deny payment for claims. May work directly for insurers or on behalf of claimants.

$70,444 / year median in Florida

+6% projected growth

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Job Description

Insurance Claims Specialist UF Health - 4.0 Gainesville, FL Job Details Full-time 23 hours ago Qualifications Insurance claims inquiry response Customer communication High school diploma or GED Medical claims submission Handling patient inquiries
Epic Full Job Description Overview:
Work alongside an engaged onsite team focused on claims resolution, compliance, and customer service excellence.
Work Style:
Onsite Location Requirement:
Gainesville, FL FTE:
Full-Time (1.0 FTE) Manages and evaluates insurance claims to ensure accurate coverage and timely processing. Investigates claims, negotiates settlements, and responds to inquiries from claimants and related parties. Assists clients in submitting claims correctly and coordinates with internal teams to facilitate efficient claim resolution. Maintains detailed records and verifies claim compliance are key to supporting audit and regulatory requirements.
Responsibilities:
Key Responsibilities Manages and evaluates insurance claims for accuracy and timely processing. Investigates claims and negotiates settlements. Responds to inquiries from claimants and related parties. Assists clients in submitting claims correctly. Coordinates with internal teams to facilitate claim resolution. Maintains detailed records and verifies claim compliance.
Qualifications:
Education High School Diploma/Equivalent Required Skills & Qualifications 2+ years of experience in insurance claims processing and support Knowledge of insurance policies and claim adjudication Experience investigating and resolving claim issues Strong communication and customer service skills Ability to maintain detailed records and ensure compliance Preferred Experience Experience verifying patient insurance eligibility and working with commercial and government payers, including BCBS, Medicare, Medicaid, and third-party insurance carriers preferred Epic experience required, with familiarity using computerized insurance billing systems and Microsoft Office programs preferred Strong communication, organizational, and problem-solving skills with the ability to work independently in a fast-paced environment Above-average math aptitude with strong attention to detail and accuracy Ability to interact professionally with patients, payers, and internal teams while exercising sound judgment in account resolution Knowledge of medical terminology preferred Demonstrated ability to consistently achieve performance expectations while managing multiple priorities under pressure