Bilingual Medical Claims Specialist

Bilingual Medical Claims Specialist (Spanish/English)Schedule: 11:30am-8pm Monday - Friday. (In-office)  -- working with California and Oregon customersLocation: Glastonbury, ConnecticutSummary:Responsible for working in a fast-paced environment and having strong interpersonal and communication skills, attention to details, outstanding ability to multi-task and prioritize, and strong analytical skills. Performs administrative tasks related to client health premiums and out of pocket medical expenses, interact with clients to provide information in response to inquiries about products and services, and handle and resolve complaints by performing the following duties.Duties and Responsibilities:Processes or adjust medical insurance claims in accordance with policies and procedures.Answers phones and respond to client inquiries related to payments made on their behalf to medical providers.Answers phones and responds to medical provider inquiries related to payments made or due to their office on their behalf of program clients.Makes outgoing calls to medical providers and insurance companies.Responsible for having the ability to read explanation of benefits and healthcare terminology.Identifies, researches, resolves claim issues, and requests for additional documentation.Promotes teamwork and service delivery success.Ensures contractual performance guarantees related to payment processing timeliness and accuracy are met.Ensures contractual performance guarantees related to various means of client communications are met such as phone, email, and mail.Processes medical payments for clients.Assists in the client appeals process.Creates and updates financial batch records for processing by accounting.Audits payment files and outgoing payments and checks accuracy of figures calculation.Manages workflow for the team to ensure service levels are achieved.Manages call logs.Works with client’s that have high medical utilization.Recommends process improvements.Performs other duties as assigned.Education/Experience:Associate's degree (A. A. / A. S.) or equivalent from two-year college or technical school; or two to four years related experience and/or training; or equivalent combination of education and experience.Specialized Training:Knowledge of medical insurance practices including enrollment, payment terms related to insurance premiums and out of pocket expenses, benefits coordination with other insurance coverage, and ensuring payer of last resort.Certificates and Licenses:Medical coding/billing or insurance claims processing preferred...Pay Statement and Pay Transparency Laws: rate of pay listed is on a per hour basis. You will be entitled to health insurance once employed for 60 days and you must work 30 hours per week, on average, per month to enroll and maintain health insurance through Complete Staffing Solutions. Once both qualifiers are met you must complete the enrollment packet and your benefits will start on the first of the subsequent month. ..It is our policy to provide equal employment opportunity to all individuals regardless of race, color, sex, sexual orientation, religion, disability, age, veteran status, ancestry, national or ethnic origin or any other legally protected class. We are committed to a diverse workforce. We value all employees' talents and support an environment that is inclusive and respectful. We are strongly committed to this policy, and believe in the concept and spirit of the law.#ZIP

Salary : $18 - $24