Medical Claims Analyst
AI summary
Fidelity Shield Insurance is hiring a Medical Claims Analyst in Nairobi to review and adjudicate medical claims, handle provider and customer queries, and oversee quality control processes. The role requires a degree or diploma in a health-related field and at least 7 years of experience in health insurance claims adjudication, including quality assurance.
- Full-time role based in Nairobi
- Requires 7 years of health insurance claims experience, including 2 years in quality assurance
- Degree or diploma in Nursing, Clinical Medicine, or Healthcare Management preferred
- Strong medical coding knowledge (ICD-10, CPT, HCPCS) is an advantage
- Application deadline is 05th Oct 2026
AI job guide
Use this guide to check salary signals, requirements, documents, application steps and safety before you apply.
AI salary guide
Not enough public dataNot enough public salary data is available for this exact role. Before applying, prepare to ask about gross pay, benefits, contract length, probation period, transport and any allowances.
Can you qualify for this role?
- Required7+ years of relevant experienceThe job post includes a minimum experience signal.
- RequiredEducation or certification mentioned in the postThe captured text mentions education, a diploma, certificate, or licence.
- PreferredPractical evidence in analyst, insurance, healthcareThe tags and summary point to skills connected with this role.
- RequiredAvailability to work in Not specifiedThe vacancy is associated with this location.
- UnclearComfort with the Full Time contract termsConfirm hours, duration, probation and benefits at the original source.
Documents to prepare
- Likely requiredUpdated CV
- Role specificCover letter or short employer message
- OptionalProfessional references
- Role specificAcademic or professional certificates
- VerifyID or passport only after verifying the employer
Application tips for this job
- Place your strongest Medical Claims Analyst evidence in the first half of your CV.
- In your cover letter or employer message, connect your experience to Fidelity Shield Insurance and the role in Not specified.
- Add concrete examples related to analyst, insurance, healthcare, ideally with measurable outcomes or clear responsibilities.
- Follow the instructions from MyJobMag Kenya; avoid sending documents to unofficial contacts or copied links.
- Confirm the deadline, interview location and employer contact before sharing personal documents.
- Prepare a polite question about pay, benefits and contract terms for later interview stages.
Source and safety check
- MyJobMag Kenya
- Original source link available
- Application method is clear
- Deadline not specified
- No major risk signal was detected in the captured text.
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Interview preparation
- What experience makes you a strong fit for this Medical Claims Analyst role in analyst, insurance?
- How have you handled responsibilities similar to those in this job post?
- Are you available to work in Not specified under the listed contract or schedule?
- Prepare examples with clear responsibilities, tools used and measurable outcomes.
- Review the source and research Fidelity Shield Insurance before the interview.
Ask what the first priorities will be in the role and how success will be measured.
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Original source description
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Fidelity Shield Insurance Company Limited is a leading general insurance provider offering a wide range of products to cater for individuals, private corporate companies, small and medium enterprises, governmental organisations and many more.
Medical Claims Analyst
Job Type: Full Time
Qualifications
- BA/BSc/HND
- ,
- Diploma
Experience
7 years
Location: Nairobi
Job Field: Insurance
,
Medical / Healthcare
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.
Check how your CV matches this job
Method of Application
- If you think you should be considered for this role, send your application to
- careers@fidelityshield.com
- by 05th Oct 2026.
- Build your CV for free.
- Download in different templates.