Claims Assurance Associate

• Verify and adjudicate program claims to determine approval, rejection or escalation in accordance with organizational policies
• Identify and document non-compliant, high-risk or potentially fraudulent claims, escalating for investigation
• Maintain accurate records of claim verifications and decisions
• Contribute to periodic reports documenting claim trends, operational risks and recommendations
• Collaborate with cross-functional teams to resolve claim-related issues
• Uphold organizational standards on confidentiality, data protection and professionalism

Qualifications & Experience:

• Diploma or Bachelor's degree in a health-related field (Public Health, Pharmacy, Nursing); Project Management, Customer Service or related qualifications also considered
• At least one year of experience in healthcare, health programs or related environments
• Experience working effectively in a remote or hybrid work environment

Skills & Competencies:

• Proficiency with Google Workspace, Microsoft Office Suite and Slack
• Experience using CRM or case management platforms (e.g., HubSpot)
• Strong analytical, problem-solving and organizational skills
• High standards of integrity, professionalism and confidentiality
• Team player with growth mindset and adaptability