Claims Reconciliation Agent

Role overview

This position focuses on checking, correcting, and balancing claim records to ensure they align with financial systems and supporting documentation. The role requires close coordination with internal teams and external healthcare providers to resolve mismatches, validate outcomes, and keep reconciliation activities accurate and timely.

Core duties

• Examine claim files to confirm that information is complete and correct.
• Make necessary corrections and adjustments to claim entries.
• Match claims data against accounting records and operational systems.
• Track down inconsistencies in claim transactions and close them within required timelines.
• Study claims data to spot recurring patterns and performance trends.
• Build reports and presentations covering reconciliation results and claim performance.
• Use analytics tools to make the reconciliation workflow more efficient.
• Support internal and external audit activities connected to claims and reconciliation.
• Keep records well-organized and ready for audit review.
• Partner with finance, processing, and customer support teams to solve claim-related issues.
• Communicate with stakeholders to address and settle discrepancies.
• Coordinate directly with healthcare providers regarding rejection rates and reconciliation findings.
• Lead reconciliation meetings with relevant stakeholders when needed.
• Take on additional ad hoc tasks as required.
• Work effectively in an environment shaped by artificial intelligence, machine learning, data analytics, and cloud-based tools, while applying data governance, security, and ethical-use standards.

Requirements

• A bachelor’s degree in a medical field, finance, business administration, insurance, or another related discipline is preferred.
• At least 2 to 3 years of experience in claims reconciliation, financial analysis, or a similar function.
• Background in the insurance or healthcare sector is preferred.
• Strong analytical thinking and problem-solving ability.
• Good command of Microsoft Excel and other data analysis tools.
• High attention to detail and accuracy.
• Strong organization and time management skills.
• Ability to work independently as well as collaboratively.
• Excellent written and spoken communication skills.
• Familiarity with claims processing systems and related software.
• Understanding of regulatory requirements tied to claims and reconciliation.
• Knowledge of basic accounting principles and practices.
• Must be legally authorized to work in the country of operation.
• Hybrid working may be available depending on business needs.

Additional information

The employer states that it does not accept unsolicited CVs or approaches from agencies. Only approved suppliers under contract are engaged, and any unsolicited submission will not be considered.

About the employer

The organization is a global B2B2C insurance and assistance company offering solutions across international health and life, travel insurance, automotive support, and assistance services. Its products are delivered through embedded partner channels or directly to customers under multiple commercial brands. The company emphasizes innovation, AI-enabled service delivery, business intelligence, data analytics, ethical AI, information security, customer focus, inclusion, and equal opportunity. Employees are expected to remain open to learning, development, and cross-functional mobility across the wider group.