Medical Claims Processor/Medical Claims Specialist

Job Title: Medical Claims Processor / Medical Claims Specialist
Pay Rate: $23.00/hour
Schedule: 11:30 AM 8:00 PM
Language Requirement: Bilingual Spanish & English required
Location: Glastonbury CT 06033

Position Summary:
We are currently seeking a detail-oriented, organized, and compassionate Medical Claims Processor / Medical Claims Specialist to join our growing team. This role requires fluency in both English and Spanish and the ability to thrive in a fast-paced environment. The ideal candidate will have strong analytical skills, a customer-focused mindset, and the ability to manage multiple priorities while maintaining accuracy and professionalism.

Key Responsibilities:

• Process and adjust medical insurance claims in accordance with company policies and procedures
  
• Respond to incoming calls from clients and medical providers regarding payment statuses and claims
  
• Make outgoing calls to providers and insurance companies to follow up on outstanding items
  
• Interpret Explanation of Benefits (EOBs) and medical terminology
  
• Identify, research, and resolve claim issues, including documentation requests
  
• Promote teamwork and ensure service delivery standards are met
  
• Process medical payments and support client appeals processes
  
• Maintain accurate financial records and assist with batch processing
  
• Audit outgoing payments for accuracy and compliance
  
• Manage team workflow and call logs
  
• Assist high-utilization clients and suggest process improvements
  
• Perform additional administrative duties as assigned

Qualifications:

• Language: Must be bilingual in Spanish and English
  
• Education: Associates degree (A.A. / A.S.) preferred, or equivalent work experience
  
• Experience: 24 years in medical claims processing, billing, or insurance customer service
  
• Computer Skills: Proficiency with Microsoft Office, internet-based tools, and proprietary software
  
• Preferred: Experience with medical coding, billing, or claims processing

Skills & Competencies:

• Strong communication and interpersonal skills
  
• Excellent attention to detail and ability to multitask
  
• Solid mathematical and reasoning abilities
  
• Ability to handle confidential information with integrity
  
• Comfortable working with diverse populations and high-volume workloads

Certifications:

• Medical billing/coding or insurance claims processing certification required

If youre passionate about healthcare administration and providing excellent support to patients and providers, we encourage you to apply today!

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