Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Claims Adjuster

$22.5 per hour

PrideStaff

Our firm is representing a professional operations center in Clearwater that specializes in high-level policy administration. We are seeking a Medical Claims Adjuster who brings a unique blend of medical coding knowledge and professional call center experience.

This is not a generic billing role; it is a specialized position designed for a "subject matter expert" who can navigate the complexities of healthcare policies, verify coding accuracy, and provide high-level clarity to policyholders. If you have a background in a medical insurance call center and are looking for a more technical, adjudication-focused career path, this is the ideal move.

Primary Duties and Responsibilities:
  • Claims Adjudication: Review medical insurance claims to determine coverage eligibility based on specific policy language and regulatory guidelines.
  • Coding Verification: Utilize ICD-10 and CPT-4 coding expertise to ensure healthcare provider billings accurately match the services and diagnoses rendered.
  • Billing Analysis: Scrutinize HCFA-1500 and UB-04 forms to identify billing inconsistencies, upcoding, or errors.
  • Policyholder Advocacy: Act as a professional point of contact for members, explaining claim determinations and providing clear, empathetic guidance on benefits.
  • Quality Assurance: Conduct rigorous audits on documentation to ensure 100% payment accuracy and strict compliance with internal standards.
  • Research & Resolution: Take initiative in resolving complex billing disputes through research and collaboration with providers.
Experience and Qualifications:
  • Insurance Call Center Experience: Proven experience working in a medical insurance call center or a high-volume health insurance service environment is required.
  • Technical Proficiency: 1+ years of experience in Medical Coding or Billing. You must be comfortable with the "nuances" of healthcare insurance (Candidates will be tested on ICD-10/CPT-4 proficiency).
  • Medicare Fluency: Previous experience specifically with Medicare or Medicare Supplement claims is a significant advantage.
  • Critical Thinking: The ability to interpret complex contract language and make informed, independent decisions regarding claim eligibility.
  • Professional Presence: Exceptional verbal communication skills with the ability to remain professional in a structured, schedule-driven environment.
  • Reliability: A track record of punctuality and dependability is essential for this on-site team.
Why Join This Team?
  • Professional Advancement: Move beyond standard billing into a strategic claims and member-support role.
  • Structured Environment: Enjoy a consistent, professional first-shift schedule with a company that values accuracy over raw volume.
  • Industry Stability: Build a long-term career in a stable and essential sector of the healthcare world.
Compensation / Pay Rate (Up to): $22.50
Vacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the Claims Adjuster in Clearwater, FL vacancy
  •  .../week until fully oriented. Come grow with GEICO’s Casualty Claims Team! It’s an exciting time! We’re in search of highly motivated...  ...preferred, but not required Must have an active Adjuster license at time of hire Outstanding customer service and professional... 
    Suggested
    Work at office
    Local area
    Relocation package
    Monday to Friday
    Afternoon shift
    3 days per week
    Early shift

    GEICO

    Largo, FL
    5 days ago
  • ## Health Insurance Claims AdjusterApplylocations: Clearwater, FLtime type: Full timeposted on: Posted 13 Days Agojob requisition id: JR3943**Health Insurance Claims Adjuster****Insurance Administrative Solutions****Clearwater, FL****About Insurance Administrative Solutions... 
    Suggested
    Contract work
    Temporary work
    Work at office
    Local area

    Insurance Administrative Solutions

    Clearwater, FL
    2 days ago
  •  ...We are happy to announce a full-time  Workers' Compensation Claims Assistant  position filled with many exciting opportunities! This...  ...received via mail, email, or phone call. Pulls and provides to Adjuster all policy and claim documents related to claims. Provides Adjuster... 
    Suggested
    Full time
    Temporary work
    Local area
    Immediate start
    Flexible hours

    FrankCrum

    Clearwater, FL
    2 days ago
  • A leading claims adjusting company in Palm Harbor is seeking an Independent Insurance Claims Adjuster to help individuals and businesses recover from disasters. The role demands being a Licensed Claims Adjuster and offers training programs for both seasoned professionals... 
    Suggested

    MileHigh Adjusters Houston

    Palm Harbor, FL
    2 days ago
  •  ...Auto-Owners Insurance Claims Professional A career at Auto-Owners is challenging and rewarding. Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs. We offer a merit-based work-from-home... 
    Suggested
    Local area
    Work from home
    3 days per week

    Auto-Owners Insurance

    Clearwater Beach, FL
    4 days ago
  •  ...INSURANCE ADJUSTER CAREER OPPORTUNITIES Licensed Adjusters & Career-Entry Applicants Welcome No prior insurance adjusting experience...  ...interested in building a career as an Independent Insurance Claims Adjuster? With continued storm activity and catastrophic weather... 
    Full time
    Flexible hours

    MileHigh Adjusters Houston Inc

    Pinellas Park, FL
    9 days ago
  •  ...Join Auto-Owners Insurance as a Bodily Injury Claims Specialist and help individuals and businesses rebuild after a loss. Responsibilities...  ..., and perform other functions or duties to properly adjust the loss. Study insurance policies, endorsements, and forms to develop... 
    Work at office
    Local area

    Auto-Owners Insurance

    Clearwater, FL
    1 day ago
  • $28.29 - $34.24 per hour

     ...and Great Careers. Your Impact at GEICO     As an Auto Claims Specialist, you’ll reassure customers and offer solutions...  ...Performance Indicators) and measurable goals preferred.    Active Adjusters license preferred  (training and exam fees provided) .... 
    Work at office
    Local area
    Immediate start
    Flexible hours
    Weekend work
    Afternoon shift

    GEICO

    Largo, FL
    2 days ago
  •  ...you could have the flexibility of work-from-home time as defined by the leadership team. Responsibilities Review and monitor open claims files. Provide assistance with coverage, liability and damage determinations. Review closed files provide feedback to claim handlers... 
    Local area
    Remote work
    Work from home

    Auto-Owners Insurance

    Clearwater, FL
    4 days ago
  •  ...Auto-Owners Insurance is looking for a qualified individual to join our claims handling team in Clearwater, Florida. This position offers the flexibility to work from home after initial in-person training. Responsibilities include reviewing open and closed claims files... 
    Remote work
    Work from home

    Auto-Owners Insurance

    Clearwater, FL
    5 days ago
  •  ...Claims Trainee A career at Auto-Owners is challenging and rewarding. Our group of caring associates create financial security by...  ...estimating and use of designated computer-based programs for loss adjustment Study, obtain, and maintain an adjuster's license(s), if... 
    Traineeship
    Local area

    Auto-Owners Insurance

    Clearwater Beach, FL
    4 days ago
  • Vehicle Condition Assessor (VCA) As a Vehicle Condition Assessor (VCA), you will play a critical role in delivering exceptional customer experiences by accurately assessing and documenting vehicle conditions for appraisals. Your work ensures quality, transparency, and...
    Night shift
    Weekend work

    CarMax

    Clearwater Beach, FL
    4 days ago
  • $14 per hour

    Poll Worker We at Kelly hear you, and we're here for you! We're seeking a Poll Worker to work at a premier organization in Pinellas, FL. Sound good? Take a closer look below. You owe it to yourself to consider this great new opportunity. Pay Rate: $14.00 per hour...
    Hourly pay
    Flexible hours
    Shift work

    Kelly

    Largo, FL
    5 days ago
  •  ...of traveling to infusion centers and elevating the standard of care through a concierge-level experience. Role: Health Insurance Claims Specialist This position reports to the Billing Manager and is essential to ensuring our services are reimbursed accurately.... 
    Work at office
    Remote work
    Monday to Friday

    Prosper Infusion

    Largo, FL
    17 days ago
  • $60k - $85k

     ...Claims Examiner Position We are growing and are in search of experienced claims examiners to join our team! This is an in-office...  ...- Bachelor's degree (preferred). Maintain currently active adjuster license and complies with continuing education ("CE") requirements... 
    Full time
    Casual work
    Work at office
    Local area
    Home office
    Monday to Friday

    West Point Technologies

    Pinellas Park, FL
    3 days ago
  •  ...Homeowners Liability Desk Adjuster CCMS & Associates is seeking a homeowners liability desk adjuster (Florida-licensed) with at least...  ...: Conduct in-depth investigations into liability claims to gather facts regarding the loss Investigate claims by obtaining... 
    Immediate start

    CCMS & Associates

    Dunedin, FL
    6 days ago
  • $60k - $85k

     ...Liability And Property Claims Examiner We are growing and in search of experienced Liability and Property Claims Examiners to join...  ...of repair or replacement of damaged or destroyed property Desk Adjust with Xactimate. Report findings of investigation, coverage interpretation... 
    Full time
    For contractors
    Casual work
    Work at office
    Local area
    Monday to Friday
    3 days per week

    West Point Technologies

    Clearwater, FL
    6 days ago
  • $100k

     ...Sr. Construction Defect Claims Representative We are eager to announce a Sr. Construction Defect Claims Representative position filled...  ...! This job contributes to the mission of FrankCrum by adjusting the most complex construction defect claims in the company's inventory... 
    For contractors
    For subcontractor

    Frank Winston Crum Insurance

    Clearwater Beach, FL
    3 days ago
  • $63k - $83k

     ...Sr. GL Claims Representative Frank Winston Crum Insurance (FWCI) issues Workers' Compensation and General Liability policies by offering...  ...! This job contributes to the mission of FrankCrum by adjusting an inventory of low to moderately complex general liability claims... 
    Hourly pay
    Temporary work
    Local area
    Immediate start
    Flexible hours

    Frank Winston Crum Insurance

    Clearwater Beach, FL
    2 days ago
  • $27.67k - $58.87k

    Lawn Specialist 330 E Douglas Rd, Oldsmar, Florida 34677 TruGreen accepts applications on an ongoing basis. Job Description At TruGreen, we believe every lawn holds potential and so does every team member. As a Residential Lawn Care Specialist, you'll be ...
    Hourly pay
    Weekly pay
    Full time
    Local area

    TruGreen

    Oldsmar, FL
    7 hours ago
  • Description Thrive Pet Healthcare is looking to add a Veterinary Internal Medicine Specialist to our team at Tampa Bay Veterinary Specialists & Emergency Care Center! Join our community of veterinary care providers for the support, tools, and resources to...
    Flexible hours
    3 days per week

    Tampa Bay Veterinary Specialists & Emergency Care Center

    Largo, FL
    a month ago
  • CONSTRUCTION SPECIALIST About the Position Ready to build a strong future in construction? We're looking for a Construction Specialist to keep our Mechanical, Electrical, and Plumbing (MEP) projects organized, efficient, and productive. This person will gain ...
    Temporary work
    Apprenticeship
    Relocation
    Flexible hours

    Power Design

    Clearwater, FL
    1 day ago
  • Inventory Control & Shipping/Receiving Specialist CECO Environmental's Inventory Control & Shipping/Receiving Specialist will manage inventory accuracy, material movement, and the efficient processing of incoming and outgoing shipments. The role ensures materials are properly...

    CECO Environmental

    Clearwater, FL
    1 day ago
  • Join Evara Health—Driven by Purpose, Powered by People Evara Health provides essential, high-quality care to the communities who need it most through 17 centers and mobile units offering primary care, dental, behavioral health, pediatrics, and more. Evara Health is ...
    Monday to Friday

    Evara Health

    Clearwater Beach, FL
    5 days ago
  • The Delivery Specialist will maintain and operate store vehicles to deliver parts and/or products to professional customers in a safe and efficient manner. This position will also collect money on C.O.D. deliveries and pick up customer returns. Bilingual candidates encouraged...
    Local area
    Immediate start
    Flexible hours

    O'Reilly Auto Parts

    Largo, FL
    1 day ago
  • Asset Protection Specialist Position Purpose: The Asset Protection Specialist is primarily responsible for preventing financial loss caused by theft and fraud and supporting safety and environmental program compliance in their assigned store/multiple stores. They...

    Home Depot

    Pinellas Park, FL
    3 days ago
  • Delivery Specialist The Delivery Specialist will maintain and operate store vehicles to deliver parts and/or products to professional customers in a safe and efficient manner. This position will also collect money on C.O.D. deliveries and pick up customer returns. Bilingual...
    Local area
    Immediate start
    Flexible hours

    O'Reilly Auto Parts

    Pinellas Park, FL
    3 days ago
  • Instructional/Certified - Position - BEHAVIOR SPECIALIST Job Number 3700271463 Start Date 08/03/2026 Open Date 06/22/2026 Closing Date 06/30/2026 # of Jobs 1 Hours per Day 7.5 Work Hours 7:45-3:15 Temporary...
    Full time
    Contract work
    Temporary work

    Pinellas County Schools

    Largo, FL
    3 days ago
  •  ...surgeries. Collaborate with healthcare providers to resolve billing discrepancies and improve processes. Review and analyze claims to ensure compliance with regulations and policies. Monitor accounts receivable and follow up on outstanding claims. Provide... 

    Bay Center for Oral & Implant Surgey

    Largo, FL
    5 days ago
  • The Youth Screening Specialist is a client serving position with responsibility for screening and assessing youth brought in for processing by law enforcement. Provides screening of youth to determine detention status, assessment of mental health or substance abuse risk...
    Immediate start
    Night shift

    Bay Area Youth Services

    Clearwater, FL
    4 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Claims Adjuster. Be the first to apply!