Procesador de reclamaciones médicas/Especialista en reclamaciones médicas Position Available In Capitol Planning Region, Connecticut

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:

Associate’s degree (A.A.