Claims Analyst

ICICI Lombard; Mumbai; On-site; INR 1,200,000 - 2,400,000; Full time

Job summary

ICICI Lombard in Mumbai seeks a Healthcare Claims Analytics professional to analyze claims data, identify utilization trends, cost drivers, and provider performance metrics. You will build dashboards using Tableau or Power BI and present actionable insights to stakeholders.

The role requires 4–7 years total experience in health insurance analytics, a Masters in Health Informatics or related field, and strong problem solving and collaboration skills.

Qualifications

• Master's degree in Health Informatics, Data Science, Statistics, Public Health, or related field.
• CA/MBA in finance, technology, Data Mining or Data Analysis.
• 3+ years of experience in healthcare claims analytics or health insurance data analysis.

Responsibilities

• Analyze healthcare claims data to identify utilization trends, cost drivers, and provider performance metrics.
• Perform data validation and quality checks on claims data from multiple sources (e.g. TPAs, providers).
• Develop dashboards and reports to present actionable insights to stakeholders using tools like Tableau, Power BI, or similar.
• Collaborate with cross-functional teams (e.g., underwriting, provider networks, actuarial, medical management) to support strategic and operational initiatives.
• Identify fraudulent, wasteful, or abusive billing patterns and recommend corrective actions.
• Assist in the development of predictive models for risk scoring, disease management, and cost forecasting.
• Build insights based on available datasets, present to management
• Generating periodic analytical reports, automate existing reports

Skills

Healthcare data analytics

Data visualization

Tableau

Power BI

Data quality checks

Cross-functional collaboration

Predictive modeling

Risk scoring

Cost forecasting

Education

Masters in Health Informatics

CA/MBA in Finance or Data Analytics

Tools

Tableau

Power BI

Job description

Role & responsibilities

• Analyze healthcare claims data to identify utilization trends, cost drivers, and provider performance metrics.
• Perform data validation and quality checks on claims data from multiple sources (e.g. TPAs, providers).
• Develop dashboards and reports to present actionable insights to stakeholders using tools like Tableau, Power BI, or similar.
• Collaborate with cross-functional teams (e.g., underwriting, provider networks, actuarial, medical management) to support strategic and operational initiatives.
• Identify fraudulent, wasteful, or abusive billing patterns and recommend corrective actions.
• Assist in the development of predictive models for risk scoring, disease management, and cost forecasting.
• Build insights based on available datasets, present to management

Generating periodic analytical reports, automate existing reports

Preferred candidate profile

Ability to understand data in the business context, Problem Solving, Soft Skills, Collaborating & Result Oriented and Able to quickly pick up and execute business requirements

Masters degree in Health Informatics, Data Science, Statistics, Public Health, or related field.

CA/MBA in finance, technology, Data Mining or Data Analysis.

Experience in Insurance domain

3+ years of experience in healthcare claims analytics or health insurance data analysis.

Total experience 4-7 years