Position: Senior Claims Auditor

Job Type: Full Time

Department: Health & Human Services

Location: HOLLYWOOD

Posted: 02/23/2026

Job Description

The incumbent in this position is responsible for being the team lead in auditing and reviewing Tribal benefit activities and processing health claims, including analyzing payments, procedures and guidelines of benefits. The individual investigates the validity of claims, reviews and settles benefit claims and processes claims for payment ensuring that Tribal Member’s health insurance claims are processed and resolved in a timely manner. The individual provides assistance and guidance to the Health Plan Program Manager, Health Plan team, Health & Human Services Leadership, Tribal Members and other relating employees on health insurance claims. The incumbent maintains accurate case files and issues reports on general claims activity. Bachelor’s degree in Health Administration, Accounting, Business Administration, Human Resources Management or related field is required. A minimum of three (5) years of experience working as team lead, supervisor, claims auditor, benefits coordinator or experience processing insurance claims is required with at least two (2) years of experience as a Certified Professional Coder (CPC), is required. An equivalent combination of education/training and experience will be considered. Possession of a valid Florida Driver’s License is required. Demonstrate excellent customer service and organizational skills. Demonstrate excellent written and verbal communication skills. Demonstrate proficiency utilizing Microsoft software packages. Ability to work a flexible schedule including evenings, weekends and holidays.

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