Claims Specialist (Employee Benefits) Spanish

Leavitt Group • South Salt Lake, UT

2d

About The Position

The Claims Specialist delivers white-glove healthcare advocacy to members of employer groups that partner with GBS. This is a challenging and deeply rewarding role for someone who enjoys problem-solving, investigation, and helping others navigate complex situations with confidence.
As a Claims Specialist, you will act as a trusted guide—owning member issues from start to resolution, advocating on their behalf, and ensuring they feel informed, supported, and cared for throughout the process. Provide Spanish translation support for members during calls, open enrollment meetings in other states, and other client interactions.

Requirements

• Willingness and ability to travel outside of the state as needed for open enrollment meetings.
• A strong investigative and analytical mindset with attention to detail.
• High levels of empathy, professionalism, and emotional intelligence.
• Excellent written and verbal communication skills.
• Ability to manage multiple cases in a fast-paced, constantly changing environment.
• A collaborative, “can-do” attitude with a willingness to jump in and help.
• Comfort seeing both the details and the big picture.
• Proficiency with Microsoft Office and comfort learning new systems.
• Demonstrated customer service experience, preferably in a healthcare or insurance setting
• Spanish fluency required, with the ability to effectively translate and communicate during member interactions, open enrollments, and meetings.
• Sound reasoning and judgment to decipher a multitude of incoming issues.
• Maintain composure, analyze situations objectively, and provide helpful assistance.
• Strong verbal & written communication.
• Ability to decipher resources for yourself and clients and know when to utilize other GBS departments.
• Must be able to effectively prioritize tickets and meet deadlines.
• Technically savvy and proficient with ongoing improvements in processes.
• Proven use and understanding of Microsoft Office.
• Strong customer service mindset with a focus on member experience
• Highly detail-oriented with strong organizational skills
• Ability to adapt to a role where each day presents new and unique challenges
• Ability to consistently attend work, meetings and training or staff events.
• Must work with respect and work well with diverse personalities.
• Must meet or exceed team and overall company expectations.
• Must work well independently as well as contribute to a team environment.

Nice To Haves

• Prior experience with insurance, claims, benefits, or EOBs is highly preferred.
• Claims background strongly preferred
• Insurance / Claims / EOB knowledge highly recommended.

Responsibilities

• Serve as a primary point of contact for members needing help navigating healthcare benefits and claims.
• Investigate and resolve denied or complex medical and pharmacy claims.
• Analyze Explanation of Benefits (EOBs), plan provisions, and coding to determine next steps.
• Advocate with insurance carriers, administrators, and providers to achieve fair and timely resolutions.
• Clearly communicate plans, timelines, and outcomes while providing reassurance and support.
• Build strong relationships with internal teams and external carrier contacts.
• Document cases accurately and stay current on evolving healthcare and benefits information.
• Provide Spanish translation support for members during calls, open enrollment meetings, and other client interactions, including traveling with brokers to translate between Spanish and English.
• Support open enrollment and client meetings, including travel as needed, to provide Spanish translation for members and clients.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed