Health Claims Analyst

This role involves analyzing health insurance claims to ensure accuracy and compliance with company policies. You will review claims data to identify discrepancies and resolve issues efficiently. The position requires attention to detail and the ability to work collaboratively with cross-functional teams to improve claims processing workflows. You will also be responsible for maintaining accurate records and providing support to internal stakeholders regarding claim inquiries.

The ideal candidate will support the claims operations team by performing detailed reviews of medical and health claims. You will investigate complex claims to determine validity and ensure proper reimbursement. This role requires a proactive approach to problem-solving and the ability to communicate findings clearly to both technical and non-technical audiences. You will contribute to the continuous improvement of the claims system and help implement best practices for data integrity.

• Review and analyze health insurance claims for accuracy and completeness
• Investigate and resolve discrepancies in claims data
• Communicate claim decisions and findings to internal stakeholders
• Maintain accurate and up-to-date claim records
• Support the claims operations team with daily tasks and inquiries
• Identify trends or issues in claims processing and suggest improvements

• Bachelor's degree in a relevant field such as Business, Finance, or Healthcare
• Basic understanding of insurance concepts and claims terminology
• Strong attention to detail and analytical skills
• Proficiency in Microsoft Office Suite, particularly Excel
• Ability to work independently and manage time effectively
• Good communication skills, both written and verbal