MEDICAL CLAIMS ANALYST
Johns Hopkins Aramco Healthcare
Employer Active
Posted 6 hrs ago
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Nationality
Any Nationality
Gender
Not Mentioned
Vacancy
1 Vacancy
Job Description
Roles & Responsibilities
Job Description Summary
Independent contributor role focused on specialized claims adjudication and pattern recognition. Responsible for handling trend-based claims while identifying process improvements and serving as a resource for junior staff.
Operational Roles & Responsibilities
- Independently review specialized and trend-based medical/dental claims
- Apply clinical and policy knowledge to complex scenarios
- Identify patterns in claim data and propose process improvements
- Conduct self-audits on 10% of own work for accuracy against clinical guidelines
- Draft initial responses to provider disputes for supervisor review
- Serve as resource for Level 1 staff on common claim scenarios
- Maintain expertise in current policy and clinical guidelines
Desired Candidate Profile
Minimum Education Required
Bachelor degree in healthcare administration, business, or related field preferred
Professional Certifications Required
-
Years of Experience
2-4 years of claims processing experience in healthcare or insurance
Languages
Arabic : Advanced
English : Advanced
Functional Competencies
- Accounts Receivable
- Billing Investigations
- Billing Statement Preparation
Core Competencies
- Excellence
- Integrity
- Accountability
- Cybersecurity
- Person-Centered Care
Company Industry
- Medical
- Healthcare
- Diagnostics
- Medical Devices
Department / Functional Area
- Insurance
- Underwriting
- Surveying
- Actuary
Keywords
- MEDICAL CLAIMS ANALYST
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Johns Hopkins Aramco Healthcare
https://careers.jhah.com/job/Dhahran-MEDICAL-CLAIMS-ANALYST_/856916723/