We have other current jobs related to this field that you can find below
-
Bilingual Medical Claims Specialist
3 weeks ago
Glastonbury, United States Complete Staffing Solutions, Inc. Full timeJob DescriptionJob DescriptionBilingual Medical Claims Specialist**Must be fluent in Spanish**Summary: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...
-
Bilingual Medical Claims Specialist
1 month ago
Glastonbury, United States Complete Staffing Solutions, Inc. Full timeJob DescriptionJob DescriptionBilingual Medical Claims Specialist**Must be fluent in Spanish**Summary: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...
-
Lead Medical Claims Specialist
3 weeks ago
Glastonbury, United States Complete Staffing Full timeLead Medical Claims Specialist We have partnered with a leading 3rd party insurance company in Glastonbury who is looking to hire 2 individuals with solid medical claims experience. 1. Lead – 4+ years of experience and has overseen a small team or is ready to take the next step in their career. – 26/hr 2. Bilingual – Must be able to speak English...
-
Lead Medical Claims Specialist
1 day ago
Glastonbury, United States Complete Staffing Inc Full timeLead Medical Claims Specialist We have partnered with a leading 3rd party insurance company in Glastonbury who is looking to hire 2 individuals with solid medical claims experience. 1. Lead – 4 years of experience and has overseen a small team or is ready to take the next step in their career. – 26/hr 2. Bilingual – Must be able to speak English and...
-
Medical Claims Specialist
1 day ago
Glastonbury, United States Complete Staffing Inc Full timeMedical Claims Specialist We are looking to hire an Medical Claims Specialist with a leading medical billing institution with an office in Glastonbury, CT. This would be a promising opportunity for any individual in the field that is looking to grow their skillset. Schedule: Monday-Friday 3 days 11:30am-8pm and 2 days 9:30am-6pm Compensation: $20-$25/hr...
-
Senior Medical Claims Analyst
2 days ago
Glastonbury, Connecticut, United States Complete Staffing Inc Full timePosition: Senior Medical Claims Analyst Complete Staffing Inc is collaborating with a prominent third-party insurance provider seeking to recruit two professionals with substantial experience in medical claims management. Key Qualifications: Leadership Experience: Minimum of 4 years in the field, with a background in supervising a small team or...
-
Claims Customer Support Specialist
3 days ago
Glastonbury, Connecticut, United States Crum and Forster Full timePosition Overview:This role is designed for individuals seeking to enhance their skills in claims management while providing exceptional customer service. The Claims Customer Support Specialist operates under general oversight and reports directly to a Team Leader or Manager.Key Responsibilities:Deliver outstanding customer service and claims management...
-
Insurance Claims Specialist
2 days ago
Glastonbury, Connecticut, United States Integris Group Full timeCompany OverviewIntegris Group is a prominent provider of medical professional liability insurance, dedicated to safeguarding healthcare practitioners and their practices. With our headquarters located in Glastonbury, Connecticut, and Jacksonville, Florida, we serve health care professionals across 22 states in the New England, Mid-Atlantic, and Southeastern...
-
Insurance Claims Specialist
3 days ago
Glastonbury, Connecticut, United States Integris Group Full timeCompany OverviewIntegris Group is a leading provider of medical professional liability insurance, dedicated to safeguarding healthcare practitioners and their practices. With a strong presence across multiple states, we are committed to making a positive impact in the healthcare community.Position TitleClaims Representative (Full Time)Role SummaryWe are...
-
Healthcare Claims Analyst
2 days ago
Glastonbury, Connecticut, United States Complete Staffing Inc Full timePosition: Medical Claims SpecialistWe are seeking a qualified Medical Claims Specialist to join a prominent medical billing organization.This role presents an excellent opportunity for professionals aiming to enhance their expertise in the medical billing sector.Work Schedule:Monday to Friday: 3 days from 11:30 AM to 8 PM and 2 days from 9:30 AM to 6...
-
CAT Claims Specialist
3 days ago
Glastonbury, Connecticut, United States CNA Financial Corporation Full timeRole Overview:This position entails overseeing the coordination of all claim resolution efforts in alignment with corporate protocols, ensuring adherence to quality and customer service benchmarks.Key Responsibilities:1. Lead and manage CAT contractors engaged in significant claims activities.2. Facilitate effective communication and collaboration among team...
-
Claims Representative
3 weeks ago
Glastonbury, United States Integris Group Full timeWork for a company that values you! Integris Group is a medical professional liability insurance carrier. We put our talents to work protecting dedicated physicians and their practices. Headquartered in Glastonbury, Connecticut and Jacksonville, Florida, we insure health care professionals in 22 states across the New England, Mid-Atlantic, and Southeast...
-
Claims Representative
3 weeks ago
Glastonbury, United States Integris Group Full timeWork for a company that values you! Integris Group is a medical professional liability insurance carrier. We put our talents to work protecting dedicated physicians and their practices. Headquartered in Glastonbury, Connecticut and Jacksonville, Florida, we insure health care professionals in 22 states across the New England, Mid-Atlantic, and Southeast...
-
Claims Administrator
3 months ago
Glastonbury, United States Integris Group Full timeWork for a company that values you!Integris Group is a medical professional liability insurance carrier. We put our talents to work protecting dedicated physicians and their practices. Headquartered in Glastonbury, Connecticut and Jacksonville, Florida, we insure health care professionals in 22 states across the New England, Mid-Atlantic, and Southeast...
-
Claims Administrator
3 months ago
Glastonbury, United States Integris Group Full timeWork for a company that values you!Integris Group is a medical professional liability insurance carrier. We put our talents to work protecting dedicated physicians and their practices. Headquartered in Glastonbury, Connecticut and Jacksonville, Florida, we insure health care professionals in 22 states across the New England, Mid-Atlantic, and Southeast...
-
Senior Claims Representative
3 weeks ago
Glastonbury, United States Integris Group Full timeWork for a company that values you!Integris Group is a medical professional liability insurance carrier. We put our talents to work protecting dedicated physicians and their practices. Headquartered in Glastonbury, Connecticut and Jacksonville, Florida, we insure health care professionals in 22 states across the New England, Mid-Atlantic, and Southeast...
-
Senior Claims Representative
3 weeks ago
Glastonbury, United States Integris Group Full timeWork for a company that values you!Integris Group is a medical professional liability insurance carrier. We put our talents to work protecting dedicated physicians and their practices. Headquartered in Glastonbury, Connecticut and Jacksonville, Florida, we insure health care professionals in 22 states across the New England, Mid-Atlantic, and Southeast...
-
Claims Phone Support
4 weeks ago
Glastonbury, United States Crum and Forster Full timeClaims Phone Support Job Locations US-CT-GLASTONBURY | US-CT-Remote Job ID 2024-3913 Category Claims Type Regular Division A&H Crum & Forster Company Overview Travel Insured International , a Crum & Forster company, is hiring for a Claims Phone Support. Travel Insured International is a leading travel insurance provider with more than 30 years...
-
Payment Specialist
3 weeks ago
Glastonbury, United States Complete Staffing Solutions, Inc. Full timeJob DescriptionJob DescriptionWe are seeking a Bilingual Payment Specialist to join an Insurance Broker company in Glastonbury! Hours: 11:30-8pm 3-days/week and 9:30-6pm 2 days/weekPay: $21-22/hourlySummary:Efficiency in a fast-paced environment with strong interpersonal and communication skills, attention to details, outstanding ability to multi-task and...
-
Payment Specialist
2 months ago
Glastonbury, United States Complete Staffing Solutions, Inc. Full timeJob DescriptionJob DescriptionWe are seeking a Bilingual Payment Specialist to join an Insurance Broker company in Glastonbury! Hours: 11:30-8pm 3-days/week and 9:30-6pm 2 days/weekPay: $21-22/hourlySummary:Efficiency in a fast-paced environment with strong interpersonal and communication skills, attention to details, outstanding ability to multi-task and...
![Complete Staffing Solutions](https://media.trabajo.org/img/noimg.jpg)
Bilingual Medical Claims Specialist
2 months ago
Job Description
Job Description
Bilingual Medical Claims Specialist
**Must be fluent in Spanish**
Summary:
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, interacts 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 include the following.
Leads the customer service and/or claims team.
Provides customer service and will processes medical claims for specific programs.
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 behalf of program clients.
Makes outgoing calls to medical providers and insurance companies, or the like.
Responsible for having the ability to read explanation of benefits, claim forms 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 as backup.
Creates and updates financial batch records as the backup for processing by accounting.
Manages workflow for the program to ensure service levels are achieved.
Approves letter queue as backup when needed for outgoing mail.
Updates policy and procedures for department.
Works with client’s that have high medical utilization.
Recommends process improvements.
Recognizes, documents and alerts the manager of escalated issues.
Reviewing and denying pending W9 claims.
Point person on staff for questions.
Performs other duties as assigned.
Education/Experience:
Associate's degree or equivalent or 4+ years of related 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. Prior lead experience preferred.
Certificates and Licenses:
Medical coding/billing strongly preferred.
#J-18808-Ljbffr