ZipRecruiter

Log In

1

Senior Fsa Claims Processor Jobs in Boca Raton, FL

ChenMed, LLC

Senior Health Economics Analyst

Miami, FL · On-site

$76K - $109K/yr

Analyzes and interpret enrollment, revenue, and claims (utilization and unit cost) data to identify ... Supports finance in the annual and multi-year planning process including development of medical ...

next page

Showing results 1-20

All JobsFsa Claims Processor JobsSenior Fsa Claims Processor JobsSenior Fsa Claims Processor Jobs in Boca Raton, FL

Senior Fsa Claims Processor information

See Boca Raton, FL salary details

$11

$18

$25

How much do senior fsa claims processor jobs pay per hour?

As of Aug 4, 2026, the average hourly pay for senior fsa claims processor in Boca Raton, FL is $18.19, according to ZipRecruiter salary data. Most workers in this role earn between $15.53 and $19.62 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Senior FSA Claims Processor, and why are they important?

To thrive as a Senior FSA Claims Processor, you need strong knowledge of flexible spending account regulations, attention to detail, and experience in claims adjudication, often supported by a background in healthcare administration or finance. Familiarity with claims processing software, HIPAA compliance, and electronic document management systems is essential. Exceptional organizational skills, analytical thinking, and effective communication help you resolve complex claims and provide outstanding service. Mastery of these skills ensures timely, accurate claims processing, compliance with regulations, and positive client experiences.

What are the main challenges faced by Senior FSA Claims Processors, and how can they be effectively managed?

Senior FSA Claims Processors often encounter complex claims that require thorough knowledge of regulations and plan specifics. Managing high volumes of claims while ensuring accuracy and compliance can be demanding, especially during peak periods. Effective time management, strong attention to detail, and ongoing communication with team members and clients are key to overcoming these challenges. Many organizations provide regular training and leverage updated claims processing software to help processors stay current and efficient.

What is the difference between Senior Fsa Claims Processor vs Fsa Claims Processor?

AspectSenior Fsa Claims ProcessorFsa Claims Processor
CredentialsTypically requires more experience, possibly advanced certificationsEntry to mid-level certifications, basic claims processing knowledge
Work EnvironmentMore complex claims, oversight responsibilitiesStandard claims processing tasks
Employer & Industry UsageUsed in healthcare, insurance companies, government agenciesCommon in similar settings, often entry to mid-level roles

The main difference between a Senior Fsa Claims Processor and an Fsa Claims Processor lies in experience, responsibilities, and complexity of claims handled. Senior roles typically involve overseeing complex claims and mentoring junior staff, while standard claims processors focus on routine tasks. Both roles are vital in healthcare and insurance industries, with senior positions requiring more expertise and experience.

What is a Senior FSA Claims Processor?

Senior FSA Claims Processors are experienced professionals who review, process, and adjudicate claims submitted for reimbursement under Flexible Spending Accounts (FSAs). They ensure that claims comply with IRS regulations and company policies, verify supporting documentation, and resolve complex or escalated issues. In addition to processing claims, they may also provide training to junior staff, answer customer inquiries, and help improve claims processing procedures.
What are popular job titles related to Senior Fsa Claims Processor jobs in Boca Raton, FL? For Senior Fsa Claims Processor jobs in Boca Raton, FL, the most frequently searched job titles are:
What job categories do people searching Senior Fsa Claims Processor jobs in Boca Raton, FL look for? The top searched job categories for Senior Fsa Claims Processor jobs in Boca Raton, FL are:
What cities near Boca Raton, FL are hiring for Senior Fsa Claims Processor jobs? Cities near Boca Raton, FL with the most Senior Fsa Claims Processor job openings:
Senior Fsa Claims Processor jobs near you

Senior Data Engineer - EDI Claims Processing

NationsBenefits

Plantation, FL • On-site

$105K - $143K/yr

Full-time

Medical

Posted 14 days ago

NationsBenefits rating

6.6

Company rating: 6.6 out of 10

Based on 16 frontline employees who took The Breakroom Quiz

309th of 481 rated business services

Job description

NationsBenefits is recognized as one of the fastest-growing companies in America and a Healthcare Fintech provider of supplemental benefits, flex cards, and member engagement solutions. We partner with managed care organizations to provide innovative healthcare solutions that drive growth, improve outcomes, reduce costs, and bring value to their members.Through our comprehensive suite of innovative supplemental benefits, fintech payment platforms, and member engagement solutions, we help health plans deliver high-quality benefits to their members that address the social determinants of health and improve member health outcomes and satisfaction.Our compliance-focused infrastructure, proprietary technology systems, and premier service delivery model allow our health plan partners to deliver high-quality, value-based care to millions of members.We offer a fulfilling work environment that attracts top talent and encourages all associates to contribute to delivering premier service to internal and external customers alike. Our goal is to transform the healthcare industry for the better! We provide career advancement opportunities from within the organization across multiple locations in the US, South America, and India.
Location: Plantation, FL (On-site)
Senior Data Engineer
About the Role
We are seeking an experienced Senior Data Engineer - EDI Claims Processing to join our growing Data Engineering team. This role is responsible for designing, developing, and maintaining enterprise-scale healthcare data integration solutions focused on HIPAA X12 EDI transactions, Medicaid encounters, and CMS compliance.
The ideal candidate has extensive experience building high-volume data pipelines using Databricks and SQL Server, a deep understanding of HIPAA X12 transaction standards, and hands-on experience supporting healthcare claims processing, clearinghouse integrations, and regulatory compliance.
This is an excellent opportunity for a healthcare data engineering professional who enjoys solving complex integration challenges while delivering reliable, scalable, and compliant data solutions.
Key Responsibilities
EDI Data Pipeline Engineering
  • Design, develop, and optimize enterprise-grade ingestion, parsing, validation, transformation, and delivery pipelines for HIPAA X12 transactions, including:
    • 837 (Professional, Institutional, Dental Claims)
    • 277CA (Claims Acknowledgment)
    • 999 (Implementation Acknowledgment)
    • 834 (Member Eligibility)
    • 835 (Remittance Advice)
  • Build scalable, high-performance ETL/ELT workflows using Databricks, PySpark, Delta Lake, and SQL Server.
Claims & Encounter Processing
  • Manage Medicaid encounter submissions, reconciliation, and error remediation with state Medicaid agencies.
  • Support CMS encounter processing by implementing regulatory updates, schema changes, and compliance requirements.
  • Collaborate with internal teams to ensure accurate and timely claims submissions.
Data Integration & Validation
  • Develop automated validation frameworks to ensure HIPAA compliance, SNIP validation, and business rule enforcement.
  • Maintain secure and reliable integrations with healthcare clearinghouses and trading partners.
  • Analyze and troubleshoot complex EDI processing issues across multiple systems.
Operational Excellence
  • Build monitoring, alerting, logging, and SLA reporting for production EDI workflows.
  • Continuously improve pipeline performance, scalability, and reliability.
  • Maintain technical documentation, mapping specifications, companion guide implementations, and data dictionaries.
Cross-Functional Collaboration
  • Partner with Claims Operations, Compliance, Product, IT Security, and external healthcare partners to support enterprise data integration initiatives.
  • Participate in architecture discussions and recommend best practices for healthcare data engineering.
Required Qualifications
  • Bachelor's degree in Computer Science, Information Technology, Engineering, or a related field (or equivalent experience).
  • 5-8+ years of experience as a Data Engineer, Integration Engineer, or Healthcare Data Engineer.
  • Strong expertise with HIPAA X12 EDI transaction standards, including:
    • 837 (Professional, Institutional, Dental)
    • 277CA
    • 999
    • 834
    • 835
  • Hands-on experience with Medicaid encounter processing and state Medicaid submissions.
  • Experience implementing CMS encounter regulations, schema updates, and compliance changes.
  • Strong experience with Databricks, PySpark, Delta Lake, and SQL Server.
  • Experience with healthcare claims validation platforms such as HIPAA Suite or similar EDI processing tools.
  • Strong understanding of:
    • HIPAA regulations
    • PHI security and data privacy
    • SNIP validation levels
    • EDI mapping, loops, segments, and companion guides
  • Experience integrating with healthcare clearinghouses such as Availity, Change Healthcare, or similar platforms.
  • Excellent troubleshooting, analytical, and problem-solving skills.
Preferred Qualifications
  • Experience with Azure Databricks or other cloud-based data engineering platforms.
  • Knowledge of healthcare interoperability standards such as FHIR and HL7.
  • Experience with encounter error remediation and state-specific Medicaid edit codes.
  • Background supporting Medicaid Managed Care, Medicare Advantage, or Accountable Care Organization (ACO) environments.
  • Experience building automated reconciliation, validation, and quality assurance frameworks for healthcare EDI transactions.
  • Familiarity with CI/CD pipelines and DevOps practices for data engineering.
Technical Skills
  • Databricks
  • PySpark
  • Delta Lake
  • SQL Server
  • T-SQL
  • Azure Databricks (Preferred)
  • HIPAA X12 EDI
  • Medicaid Encounters
  • CMS Encounter Processing
  • HIPAA Suite (or equivalent)
  • ETL / ELT Development
  • Data Validation & Reconciliation
  • Healthcare Claims Processing
  • Azure (Preferred)
What You'll Bring
  • Strong ownership mindset with the ability to work independently on complex technical initiatives.
  • Excellent communication and collaboration skills across technical and business teams.
  • Passion for building scalable, reliable, and compliant healthcare data solutions.
  • Commitment to delivering high-quality data engineering solutions in a fast-paced healthcare environment.
Why Join Us?
Join a collaborative team where you'll help build mission-critical healthcare data platforms that support millions of healthcare transactions. You'll work with modern data technologies, contribute to large-scale integration initiatives, and play a key role in ensuring secure, compliant, and high-quality healthcare data processing.
NationsBenefits is an Equal Opportunity Employer.

What NationsBenefits employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply