Senior Claims Processor

Contract-to-Hire (9 Months) | Potential for Direct Placement Compensation: $23–$32/hr Overview

Our client, a long‑standing and reputable benefits organization, is seeking an experienced Senior Claims Processor to join their U.S. Benefits team. This small, highly skilled group operates within a multi‑employer trust environment and is preparing for the retirement of several senior staff members. This role is critical for claims processing, auditing, adjudication logic, and long‑term knowledge transfer.

Ideal candidates bring deep experience in medical and/or dental claims and thrive in a low‑volume, high‑accuracy setting.

• Process medical and dental claims from intake through final resolution
• Perform data entry, validation, and detailed claims adjudication
• Conduct follow‑ups, resolve issues, and manage appeals
• Ensure accurate application of benefit plan rules and adjudication logic

• Audit claims processed by other team members
• Maintain strong documentation in alignment with regulatory standards
• Support internal compliance and accuracy initiatives

• Assist with claims system configuration and processing logic
• Support reporting, data analysis, and coding‑related activities
• Identify opportunities for process improvements

• Respond to member and provider inquiries via phone and email (moderate volume)
• Collaborate with internal teams to ensure timely and accurate resolutions
• A few thousand claims per month shared across a 3–4 person team
• Emphasis on accuracy, detail, and quality
  —not production quotas

• 5+ years of medical and/or dental claims processing experience
• Strong understanding of claims adjudication logic and appeals
• Experience auditing claims for accuracy and compliance
• Proficiency with claims processing systems and configuration tools
• Comfortable handling inquiries via phone and email
• High attention to detail and ability to work independently
• Ability to thrive in a small, collaborative team environment

• Reporting or data analysis experience
• Background in coding or claims system configuration
• Experience with multi‑employer trusts or benefits administration
• Exposure to process improvement or operational enhancement initiatives

• Succession‑planning role with long‑tenured staff
• Join a stable organization with 100+ years of history
• Work directly with experienced leadership
• Strong focus on accuracy, compliance, and institutional knowledge retention