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

Experience

Technical Skills

Soft Skills

Working Conditions

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 :

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.