Florida Auto PIP​/Medical Adjuster

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.

• 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

• 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

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