Medical Claims Analyst Job Fidelity Shield Insurance

Job description

Medical Jobs. Fidelity Shield Jobs. Medical Claims Analyst reviewing and adjudicating medical claims and monitoring quality control processes, requiring a bachelor’s degree or diploma in Nursing, Clinical Medicine or Healthcare Management, knowledge of medical coding and at least 7 years health insurance claims adjudication experience with 2 years in quality assurance, in a health insurance environment, on-site role.

Key Responsibilities

The key deliverables for the role are;

• Review and assess medical claims for accuracy, completeness, and eligibility based on policy terms, medical guidelines, and coding systems
• Attending to providers, specialists and customer queries by determining their requirements, answering to these inquiries, resolving problems, and ensuring good service as a friendly cost.
• Adjudicating inpatient and outpatient medical claims while verifying the accuracy of information provided.
• Oversee quality control processes and claims assessment, adjudication, payment, and communication
• Monitor the quality of services provided by third-party vendors to ensure contractual obligations and service standards are met.

Qualifications;

• Bachelor’s degree or a Diploma in Nursing, Clinical Medicine, Healthcare Management.
• Strong background in medical claims assessment will be a plus including knowledge of medical terminology, coding (ICD-10, CPT, HCPCS), and treatment procedures.
• At least 7 years’ of experience in health insurance claims adjudication, with at least 2 year out of those, in quality assurance.

How to Apply

If you think you should be considered for this role, send your application to careers@fidelityshield.com by 05th Oct 2026.

Requirements

Apply by email: careers@fidelityshield.com