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Senior Claims Analyst
hace 3 horas
Senior Claims Analyst / Claims Team Lead (Remote)
Summary
An experienced claims professional is sought to support an international claims operation. The role focuses on accurate and timely processing of U.S. and international healthcare claims, supporting quality standards, resolving complex cases, and contributing to process improvements. Senior candidates may also provide team leadership and coaching.
Key Responsibilities
- Review, analyse, and adjudicate U.S. and international medical claims in line with payer requirements and SLAs.
- Handle complex claims, escalations, and benefit or pricing validations.
- Liaise with PPO networks and healthcare providers to resolve claim issues.
- Ensure compliance with policy terms, billing codes, and regulatory standards.
- Support process optimisation, automation, and efficiency initiatives.
- Collaborate with internal teams such as Finance and Customer Service.
- Coach and support junior analysts where applicable.
Requirements
- Degree or equivalent experience in healthcare, business, or a related field.
- 2+ years' experience in U.S. and international medical claims processing.
- Strong knowledge of U.S. healthcare reimbursement, EOBs, PPO networks, and billing codes.
- Experience with claims systems and strong Excel skills.
- Excellent analytical skills and attention to detail.
- Fluent English required; additional languages an advantage.
- Comfortable working in a fast-paced, multicultural, remote environment.
Offer
- Competitive compensation and benefits.
- Fully remote, flexible working model.
- Growth opportunities within an international organisation.
