CLAIMS ANALYST

Job Summary

We are seeking a detail-oriented Claims Analyst with strong analytical and mathematical skills to review, evaluate, and process healthcare claims. The role ensures accuracy, compliance, and efficiency in claims handling in accordance with HMO guidelines and company policies.

Responsibilities

• Review, analyze, and process healthcare claims accurately and efficiently
• Validate claim details, computations, and supporting documents
• Identify discrepancies, errors, and potential issues in claims submissions
• Apply logical and systems-based analysis in reviewing claims workflows and procedures
• Coordinate with internal teams and providers for clarification and resolution of claims concerns
• Ensure compliance with processing standards, policies, and timelines
• Maintain accurate records and documentation of processed claims

Qualifications

• Graduate of Industrial Engineering, BS Mathematics, Applied Sciences, or related field
• Strong background in math, system analysis, and procedures
• Analytical thinking with high attention to detail
• Proficient in MS Office (especially Excel)
• Ability to work in a fast-paced, process-driven environment
• Strong problem-solving and logical reasoning skills