ADM - Claims Administration Specialist

UNAVAILABLE; Boston (MA); Remote; Full time

Job summary

An established industry player is seeking a Claims Administration Specialist for a remote role. This position involves administering claims across various health and pre-tax benefit plans, ensuring compliance with guidelines, and providing exceptional customer service. The ideal candidate will have a strong understanding of HSA, HRA, and FSA plans, along with excellent communication skills to manage inquiries and resolve issues effectively. Join a company that values collaboration and offers comprehensive benefits, including medical, dental, and generous paid time off. If you're ready to make a difference in the lives of clients, this is the opportunity for you.

Benefits

Medical Insurance

Dental Insurance

Life Insurance

Disability Insurance

401k

Generous Paid Time Off

Qualifications

• 1-2 years of customer service experience preferred.
• Strong knowledge of HSA, HRA, and FSA plans.

Responsibilities

• Administer claims for health and pre-tax benefit plans.
• Respond to inquiries from internal teams and customers.
• Monitor pending claims and ensure timely reimbursement.

Skills

Customer Service

Communication Skills

Multitasking

Data Analysis

Problem Solving

Education

Associate Degree

Tools

Excel

WEX CDH

Job description

Overview

Alera Group company is looking for a Claims Administration Specialist. This is a remote position!

Alera Group was founded in 2017 and has grown to become the 15th largest broker of US business. We are passionate about our clients’ success in the areas of Employee Benefits, Property and Casualty Insurance, Retirement Plan Services, and Wealth Services. With a network of offices nationwide, our commitment to collaboration allows us to offer national resources combined with local service.

Responsibilities

• Administer claims across a variety of health and pre-tax benefit plans including HSA, HRA, FSA, DCA, LSA, and Qualified Transportation Accounts, ensuring accurate processing in compliance with plan guidelines.
• Respond promptly and professionally to inquiries from internal teams, external customers, vendors, and partners, providing clear guidance and resolution related to claims administration.
• Educate customers on account rules, features, and IRS regulations, promoting understanding and proper use of pre-tax benefits.
• Independently investigate and resolve claims-related issues by researching discrepancies, troubleshooting processing errors, and collaborating with internal departments for complex resolutions.
• Monitor and follow up on pending claims, verify documentation for accuracy, and ensure timely reimbursement and resolution in alignment with service level expectations.
• Process claims payments and refunds using internal systems and banking platforms, while supporting department initiatives and project-specific tasks to meet organizational goals.
• Maintain strict adherence to HIPAA privacy rules and stay current on evolving regulatory requirements, company offerings, and benefit plan features to ensure compliance and quality service delivery.

Qualifications

• Education Required: Associate degree
• Experience: Minimum 1–2-year experience in customer service role preferred
• Possess strong working knowledge of HSA, HRA, and FSA plans, with the ability to stay current on evolving regulations and compliance requirements.
• Demonstrate excellent customer service, communication, and interpersonal skills, including the ability to manage escalations professionally.
• Excel at multitasking and prioritizing in a dynamic environment, seamlessly switching between tasks and internet-based systems throughout the day.
• Proficient in Excel and data analysis, with the ability to interpret and manipulate large data sets for actionable insights.
• Apply basic project management skills and experience with platforms such as WEX CDH to support operational efficiency and deliver high-quality results.

Additional Information

Alera Group offers comprehensive benefits to our colleagues, including medical, dental, life and disability insurance, 401k, generous paid time off and much more.

The hourly rate is $20-$24/hr, depending on experience.

We're an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status, or any other protected class.