Healthcare Claims Analyst

Job Summary

We are seeking a detail-oriented and analytical Healthcare Claims Analyst to join our team. In this role, you will manage claims processing within the healthcare space, ensuring accuracy, efficiency, and compliance with payer requirements. You will collaborate with medical teams and interact with patients to resolve claims-related issues while supporting data entry, analysis, and reporting activities.

Key Responsibilities

• Review, process, and manage healthcare claims from submission to resolution, ensuring timely and accurate outcomes.
• Liaise with insurance payers, medical teams, and patients to clarify claim details, resolve discrepancies, and facilitate payments.
• Perform data entry, maintain records, and generate reports on claims status, trends, and performance metrics.
• Analyze claims data to identify patterns, errors, or opportunities for process improvement.
• Ensure compliance with company policies, payer guidelines, and regulatory standards.
• Handle queries and disputes professionally, providing clear communication and follow-up.
• Support the team in a fast-paced environment, multitasking across priorities and deadlines.

Qualifications

• Education: Degree or Diploma in Business Administration, Economics, Finance, or other business-related fields from a recognized institution.
• Accounting Qualification: CPA Part II or ACCA 2.
• Experience: At least one (1) year of experience in claims management within the healthcare space. Experience working with insurance payers is essential.
• Technical Skills: Proficient computer skills for data entry, analysis, and report generation.

Skills and Competencies

• Good interpersonal and communication skills for effective collaboration with the medical team and patient interaction.
• Excellent attention to detail and ability to work with precision.
• Ability to work in a fast-paced environment, multitask, and prioritize workload.

Working Conditions

This role operates in a dynamic office environment with standard working hours. Occasional overtime may be required to meet deadlines. The position involves regular interaction with internal teams and external stakeholders.