Hire a Top Medical Claims Processor in LatAm. Same Quality. 50% Less.

South helps growing companies find, hire, and pay top Latin American talent. Build high-performing teams in 21 days or less.

Latin American Talent Savings

Hire 

Medical Claims Processor

s for up to

50

% less

We’ve helped hundreds of clients hire amazing staff in Latin America.

3600

/month 

Average US Salary

1800

/month 

Average LatAm Salary

50

%

Potential Savings

See a few of our 120,000 pre-vetted professionals

Andrea M.
Medical Claims Processor
Medical Claims Assistant
Junior
Middle
Senior
Mexico
2
years exp.
Office Ally
Availity
Medicare
Medicaid
Google Sheets
Monthly Salary
$
0.8
k - $
1.3
k
Richard L.
Medical Claims Processor
Medical Claims Processor
Junior
Middle
Senior
Venezuela
4
years exp.
QNXT
Facets
EZ-CAP
Epic
Cerner
Waystar
Monthly Salary
$
1.8
k - $
2.3
k
Brian M.
Medical Claims Processor
Lead Claims Analyst
Junior
Middle
Senior
Costa Rica
6
years exp.
TruBridge
HealthEdge
Epic Resolute
Power BI
Tableau
RPA
Contract management
Monthly Salary
$
2.8
k - $
3.3
k
Our talent has worked at top startups and Fortune 500 companies

Medical Claims Processor

Tasks:

  • Review and evaluate insurance claims for completeness and accuracy.
  • Verify patient eligibility and coverage details.
  • Process claims according to insurance policies and guidelines.
  • Identify and investigate discrepancies or missing information.
  • Approve or deny claims based on policy criteria.
  • Calculate benefit amounts and determine reimbursement levels.
  • Enter claim information into processing systems and databases.
  • Communicate with healthcare providers and patients to resolve issues.
  • Ensure compliance with HIPAA and insurance regulations.
  • Follow up on pending or disputed claims.
  • Maintain accurate and organized records of processed claims.
  • Stay updated on changes in insurance policies and coding standards.

Medical Claims Processor

Qualifications:

  • High school diploma or equivalent; additional training in medical billing or insurance is a plus.
  • Knowledge of medical terminology, coding systems, and healthcare procedures.
  • Familiarity with insurance claim processes and regulations.
  • Proficiency in claims processing software and data entry.
  • Strong attention to detail and accuracy.
  • Good analytical and problem-solving skills.
  • Ability to interpret insurance policies and guidelines.
  • Effective written and verbal communication skills.
  • Understanding of HIPAA and patient confidentiality requirements.
  • Ability to manage multiple tasks and meet deadlines.

Frequently Asked Questions:

What does a Medical Claims Processor do?

A Medical Claims Processor reviews insurance claims for completeness, verifies coverage, processes the claim against policy rules, and approves or denies based on documentation. They work either on the payer side at insurance carriers or on the provider side managing the claim through to adjudication.

How much does it cost to hire a Medical Claims Processor?

Hiring a Medical Claims Processor in the U.S. is significantly more expensive than in Latin America, with an average U.S. salary of $3,600 per month compared with an average Latin American salary of $1,800 per month, creating potential savings of up to 50%. Working with South gives you access to a vetted pool of LatAm Medical Claims Processors on contracts that handle compliance and payroll, with same-time-zone collaboration.

Can a U.S.-based company hire a remote Medical Claims Processor from Latin America?

Yes. The work is almost entirely software-based and HIPAA-compliant. LatAm claims processors with prior BPO healthcare experience can run high volumes on systems like Facets, QNXT, or HealthRules from outside the U.S. South contracts locally, runs payroll and compliance, and keeps them in your time zone.

What skills should I look for when hiring a Medical Claims Processor?

Strong knowledge of ICD-10, CPT, and HCPCS coding, familiarity with insurance policy interpretation, attention to detail under volume, and the ability to flag potential fraud or upcoding. Senior signal is the ability to handle complex claims (DME, behavioral health, surgical bundles) without sending everything to a supervisor.

What tools and software should a Medical Claims Processor know?

Payer platforms like Facets, QNXT, HealthRules, plus EHR systems like Epic and Cerner on the provider side. Excel and Access for ad-hoc analysis, Microsoft 365 or Google Workspace for documents, and HIPAA-compliant messaging for case work.

How is a Medical Claims Processor different from related roles?

A Medical Billing Specialist sits on the provider side and gets claims paid. A Medical Claims Processor sits on the payer side (or in a TPA) and decides whether the claim should be paid. A Medical Coder assigns the diagnostic and procedure codes that both sides depend on.

How can South help me hire a Medical Claims Processor?

South vets LatAm claims processors with coding tests, real claim review exercises, and references from prior U.S. payers or TPAs. You see a shortlist in seven to ten days, run your own interviews, and onboard in one to two weeks. South handles the contract, payroll, and compliance, plus a replacement guarantee. Schedule a free call here to get started!

Interview Questions:

  • Walk me through how you adjudicate a claim from intake to decision.
  • Show me how you read an EOB and identify the line items at risk.
  • What is the difference between a denial and a rejection? Give an example of each.
  • I give you a high-dollar claim with mismatched modifiers. Walk me through your review.
  • How do you handle an out-of-network provider claim?
  • Describe how you flag a claim for fraud or upcoding. What signals do you look for?
  • What is your daily claim volume target, and how do you sustain it without dropping accuracy?
  • Walk me through bundling rules. How do they affect adjudication?
  • How do you handle COB (coordination of benefits) on a claim with two payers?
  • What is your QA error rate, and what is the most common reason claims come back to you?

Related Roles:

Related Skills:

Why Latin America?

Hire teammates, not offshore resources.

US Time Zones

Argentina & Brazil are just one hour apart from New York. Your Latin America teammates work when you do so you can collaborate all day long.

Excellent English

We screen all candidates for excellent spoken and written English. They are ready to jump right in.

Cultural Fit

We make sure all candidates are a strong professional and culture fit. They are already accustomed to working remotely.

Cost Savings

Latin American salaries are 30-80% less than US-equivalents. Grow your team with top 1% nearshore talent without breaking your budget.

Why Choose South?

We try harder.

Full-Service Talent Partner

We take care of all the headaches of hiring, from recruiting, vetting, compliance, and global payroll. We work to understand your specific needs and to provide unreasonable hospitality every step of the way.

Trusted Top Talent

Tap into our pool of over 120,000 pre-vetted professionals who have worked for Fortune 500 companies and top startups. Our rigorous selection process accepts only the top 0.5% of Latin American talent.

Transparent Pricing

No hidden fees or surprises here. With risk-free hiring, you only pay if you find the right candidate. You’ll know exactly how much you pay for your hires and our fee.

Zero Compliance Headaches

South handles all legal and compliance aspects of employment, ensuring adherence to local regulations in every country we operate in. Bring on global talent confidently, without legal risks or administrative headaches.

Satisfaction Guaranteed

Your satisfaction is our highest priority. If your new team member doesn’t meet your needs perfectly, we are happy to provide a quick replacement.

Ready to elevate your team? Start hiring remotely in Latin America today!

Start hiring

How South Works

Hiring great employees globally can be tough. We make it easy with our hassle-free hiring.
01.
Describe the Role
We get to know you, your company, and the job you are looking to fill. Then, we put together a job listing to start finding potential candidates for your specific role.

Time saved: 5 days
02.
We Search & Vet
We search far and wide for the best talent that meets your goals. Then, we run them through English assessments, internet speed tests, the initial interview, behavioral and communication tests, and run reference checks on your behalf. After the candidates survive our gauntlet, we present the best pre-vetted options for you to choose from.

Time saved: 10 days
03.
Hire with Confidence
After you select the best person for the job, we set you up for success with our battle-tested processes for remote onboarding. We handle compliance, payroll, and any mess for you. Then, you are off and running with your new favorite employee!

Money saved: $30k-$100k / year
Why clients love us for hassle-free hiring...

"South was a low-risk, high ROI way to source new talent. In under two weeks, we hired a Customer Support and a SEO Specialist and were able to scale up without getting bogged down in hiring."

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Brent Sanders
CEO, Scout Software

"I got a Finance & Data Manager for under $40k a year, that would have cost me $180k in the US. South knocked it out of the park for us! Their thorough hiring funnel delivered exactly the quality I was looking for. Over half our team is in Latin America now. "

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Trevor Houghton
CEO, Pass Galleries

"Working with South has honestly changed my entire business. I built my whole team with them. They are by far the best."

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Brian Blum
Founder, Nibble Studio

Frequently asked questions

If you have any further questions, get in touch with our friendly team!
Why hire in Latin America?

The region has the perfect mix of everything you want in remote employees: English skills, shared time zones, hard-working, and depth of talent. They are already accustomed to working remotely for top US startups and Fortune 500 companies.

Can they work my time zone?

Absolutely! The US and Latin America have basically the same time zones. No Latin American city is more than two hours ahead of EST.

What tasks can they do? What roles can I hire for? 

Every hire is sourced based on your exact needs. They will arrive ready to support your business right away. They can do basically any tasks done remotely, but we recommend starting them as support so your team has more bandwidth for high-value strategic tasks.

All types of roles - customer service, executive assistant, sales, accounting, email marketing, lead generation, content writers, operations, social media marketing, and more!

How do I pay them? Any tax or visa issues?

You can pay directly through us (most popular) or we can connect you with one of our payroll partners.

You don't have to deal with any American labor laws / taxes when hiring full-time remote contractors. They aren't US-based, so no visas or sponsorships to deal with either.

What does this cost?

We recommend market pay which varies for each role. See our salary guide and success stories for some ideas.

Then, we have two different models:

Staffing (most popular) - We charge a small monthly fee for each employee's monthly salary to make the process hassle-free. The fee covers sourcing, recruiting, admin, payroll, compliance, ongoing support, and a free replacement if necessary at any point. There are no cancellation fees or minimum commitments. You only pay if you make a hire.

Headhunting - A one-time simple fee once we've found the perfect candidate. This comes with a 120-day replacement guarantee.

For both options, you only pay something if we find you someone great that you want to hire.

Do I have to hire full-time?

Yes, we only recruit for full-time and we strongly recommend full-time hiring if you can. Stability (full-time & long-term) is highly sought after abroad. The top caliber candidates are only looking for full-time work.

You're also going to spend time training and getting them up to speed on your processes. It would be a waste to do that over and over again with new people all the time.

Do I have to hire for an individual role or can they handle multiple roles?

We recommend training new hires on one thing at a time.

For example, once they get up to speed on lead generation, you can add the next role writing blog posts or whatever you'd like. You can definitely overlap roles until you have enough work for multiple people.

How can they be 70% less?

The cost of living is much less in Latin American countries. Many of our employees are able to own homes, raise families, provide for their parents, and have in-home help of their own with their salaries.

How does the money-back guarantee work?

If you aren't happy with your hire in the first 120 days, we will work with you to conduct a second round of search for the same role for free.

How do I reach out if I have a question?

Just email us at Hello@HireInSouth.com and we will get back to you with an answer as soon as possible.

Start hiring today!
Free to interview, pay nothing until you hire.