Medical Claims Processor

Job Description

Job Summary

FCE Benefit Administrators, Inc. is seeking a detail-oriented and motivated Medical Claims Processor to join our dynamic and growing team. The ideal candidate will be responsible for the accurate and timely processing of a wide range of claims while ensuring compliance with company standards and regulatory requirements. This role requires strong attention to detail, effective communication skills, and the ability to work efficiently in a fast-paced environment.

Key Responsibilities

• Accurately process a variety of claim types, including Medical, Vision, Dental, HRA, Critical Illness, and Accident claims.
• Manage the entire claim lifecycle, including adjustments, voids, and payment reissues.
• Conduct audits on processed claims to ensure accuracy and compliance with policies.
• Serve as a point of contact for claim-related inquiries from members, providers, and internal AE (Account Executive) and CS (Customer Service) teams.
• Handle escalated client questions and issues via phone and email with professionalism and urgency.
• Participate in special projects and organizational initiatives as assigned.
• Assist with training and mentoring team members (for more experienced candidates).

Education

• High school diploma or equivalent required.
• Associate’s degree or vocational training in a related field (e.g., Medical Billing & Coding, Business Administration) preferred.

Experience

• 1–3 years of experience in medical claims processing, data entry, customer service, or a general administrative role required.

Technical Skills

• Proficiency in Microsoft Office Suite (Excel, Word, Outlook).
• Strong data entry capabilities and 10-key proficiency.
• Familiarity with claims management platforms or Electronic Health Record (EHR) systems preferred.

Soft Skills

• Exceptional attention to detail and strong organizational abilities.
• Clear written and verbal communication skills.
• Strong problem-solving and critical thinking abilities.
• Ability to work independently while managing a high volume of tasks in a fast-paced environment.
• Commitment to maintaining confidentiality and handling sensitive information with integrity.

Working Conditions

• Standard office environment.
• Prolonged periods of sitting and computer use may be required.
• Ability to lift up to 20 lbs occasionally (e.g., handling physical records or mail).

Benefits Offered

We understand that top talent is attracted to organizations offering competitive compensation, comprehensive benefits, and opportunities for professional growth. FCE offers a robust benefits package including:

• Medical, Dental, and Vision Coverage
• Disability Insurance
• 401(k) with Company Match
• Flexible Spending Accounts (FSA)
• Health Savings Account (HSA) Contributions
• Fitness Membership Discounts
• Company-paid Life Insurance
• Tuition/Professional Development Reimbursement
• Employee Assistance Programs
• Paid Time Off (PTO)

About FCE Benefit Administrators, Inc.

With nearly 30 years of experience, FCE Benefit Administrators, Inc. has helped hundreds of For-Profit and Not-For-Profit organizations achieve full compliance under the Service Contract Act (SCA), Davis-Bacon Act (DBA), Javits-Wagner-O’Day (JWOD), and related federal legislation. As trusted experts in government contracts, we specialize in the administration of bona-fide fringe benefit plans through an irrevocable funding arrangement, ensuring full compliance with SCA requirements.

Equal Opportunity Employer

FCE is an equal opportunity employer and is committed to creating an inclusive and diverse workplace.