Bilingual Medical Claims Processor / Medical Claims Specialist

Location: Glastonbury, CT 06033 (On-site)
Schedule: Monday–Friday | 11:30 AM – 8:00 PM
Pay Rate: $24.00/hour (Based on experience)
Language Requirement: Bilingual – Spanish & English (Required)

Position Overview

We are seeking a detail-oriented, organized, and compassionate Bilingual Medical Claims Processor / Medical Claims Specialist to join our growing team in Glastonbury, CT.

This role is ideal for a professional who thrives in a fast-paced healthcare environment, demonstrates strong analytical abilities, and is committed to delivering exceptional service to patients, providers, and clients. Fluency in both Spanish and English is required to effectively support our diverse client base.

Key Responsibilities

• Process and adjust medical insurance claims in accordance with company policies and industry regulations

  
  

• Review and interpret Explanation of Benefits (EOBs) and medical terminology

  
  

• Research, identify, and resolve claim discrepancies, including documentation requests

  
  

• Respond to inbound calls from clients and medical providers regarding claim status and payments

  
  

• Place outbound calls to providers and insurance companies to follow up on outstanding claims

  
  

• Process medical payments and assist with client appeals

  
  

• Maintain accurate financial records and assist with batch processing

  
  

• Audit outgoing payments to ensure accuracy and compliance

  
  

• Monitor workflow, manage call logs, and support team productivity

  
  

• Assist high-utilization clients and recommend process improvements

  
  

• Perform additional administrative and operational duties as assigned

Qualifications

• Language: Fluent in Spanish and English (Required)

  
  

• Education: Associate’s degree (A.A. or A.S.) preferred, or equivalent relevant experience

  
  

• Experience: 2–4 years of experience in medical claims processing, medical billing, or insurance customer service

  
  

• Technical Skills: Proficiency in Microsoft Office, internet-based systems, and claims management software

  
  

• Preferred: Experience with medical coding, billing procedures, or insurance claims processing

Skills & Competencies

• Strong verbal and written communication skills

  
  

• Exceptional attention to detail and accuracy

  
  

• Ability to manage multiple priorities in a high-volume environment

  
  

• Solid mathematical and analytical skills

  
  

• High level of professionalism and confidentiality

  
  

• Ability to work effectively with diverse populations

  
  

• Team-oriented with a proactive, solution-driven mindset

Certifications

• Medical billing/coding or insurance claims processing certification (Required)

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