Claims Specialist

We’re looking for a Claims Specialist who is ready to take ownership of complex claim adjudication tasks within our Flex administration programs, including Section 125, 129, 132, 105(h), and more. In this role, you’ll play a key part in ensuring accuracy, efficiency, and an exceptional experience for our customers and clients. If you enjoy detailed work, problem-solving, and making a meaningful impact behind the scenes, this is a great opportunity to grow your expertise.

Key Responsibilities

• Accurately process claims within established timelines
• Review and complete claim adjustment requests
• Research claim reversal requests to determine approval or denial
• Manage debit card dispute workflows, including fraudulent or disputed transactions
• Provide clear and professional responses to routine phone and written inquiries related to claim processing
• Issue manual adverse determination letters, notifying participants of required information or appeal rights in accordance with plan rules
• Adjudicate transactions that fail auto-review and determine whether additional documentation is needed