Medical Claims Analyst

Afia Concept Claims Settling Agency (ACS) is hiring for the Medical Claims Analyst position in Nairobi. This is a full time, mid level role. Qualification level: Bachelors. Afia Concept Claims Settling Agency (ACS) is a forward-thinking healthcare consulting firm operating in East Africa, with headquarters in Nairobi, Kenya. Applications close on 2 November 2026.

Established to bridge the gap between healthcare infrastructure and accessible, high-quality services, ACS offers end-to-end solutions in healthcare facility design, health financing advisory, digital health, and operational management.Role Purpose

It requires someone who can interpret medical documentation, apply benefit rules, identify anomalies, and contribute to the continuous improvement of ACS's claims processes.

Key responsibilities

• The Medical Claims Analyst role is responsible for the accurate, timely, and compliant adjudication of medical claims submitted by healthcare providers on behalf of scheme members.
• Review, assess, and adjudicate inpatient, outpatient, dental, optical, pharmacy, and reimbursement claims in accordance with scheme benefits, policy terms, exclusions, limitations, and contractual provider agreements.

Requirements

• Diploma or Bachelor's Degree in Nursing, Clinical Medicine, Health Records & Information Management, Public Health, or a related health sciences field.
• Professional qualifications in AIIK, ACII, or Certificate in Insurance…

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