Senior Claims Analyst

FJN Solutions; A distancia; EUR 30.000 - 50.000; Jornada completa

Descripción de la vacante

A healthcare solutions provider is seeking a Senior Claims Analyst / Claims Team Lead for a fully remote role in Madrid. The successful candidate will process U.S. and international healthcare claims, ensuring compliance and contributing to process improvements. With a strong focus on analytical skills and attention to detail, applicants should have experience in medical claims and possess a relevant degree. This position offers competitive compensation, benefits, and opportunities for growth within an international organization.

Servicios

Competitive compensation and benefits

Fully remote, flexible working model

Growth opportunities within an international organization

Formación

• 2+ years’ experience in U.S. and international medical claims processing.
• Strong knowledge of U.S. healthcare reimbursement, EOBs, and billing codes.
• Experience with claims systems.

Responsabilidades

• Review, analyze, and adjudicate U.S. and international medical claims.
• Handle complex claims, escalations, and benefit validations.
• Ensure compliance with policy terms and regulatory standards.

Conocimientos

Analytical skills

Attention to detail

Fluent English

Strong Excel skills

Educación

Degree in healthcare, business, or related field

Descripción del empleo

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.