Administration Specialist

We are seeking a highly organised and analytical Administration Specialist to join a dynamic healthcare and insurance operations environment.

The successful candidate will play a key role in overseeing administrative processes, supporting medical claims operations, cost containment initiatives, and case management activities. This position requires a detail-oriented professional capable of balancing operational efficiency, financial stewardship, and exceptional service delivery while ensuring compliance with regulatory and company standards.

• Oversee and optimise administrative processes related to medical claims and healthcare operations.
• Ensure compliance with internal policies, regulatory requirements, and data protection standards.
• Coordinate with assistance, claims, medical, and provider network teams to ensure smooth operations.
• Process vendor invoices and payments through SAP.
• Perform payment runs accurately and within established deadlines.
• Prepare reports, collect and analyse data, and provide administrative support to management.
• Maintain accurate digital and paper-based records, files, and archives.
• Contribute to the development and maintenance of process documentation and operational manuals.

• Support the implementation of cost containment strategies aimed at reducing claim costs while maintaining quality of care.
• Monitor billing practices and identify discrepancies, duplicate charges, or non-covered services.
• Collaborate with provider networks to support cost-effective healthcare solutions.
• Assist in reviewing high-cost treatments and healthcare utilisation trends.
• Support initiatives focused on healthcare cost optimisation and resource management.

• Assist in monitoring and coordinating case management activities.
• Support the identification and management of complex or high-cost cases.
• Help ensure effective care coordination and positive customer outcomes.
• Promote efficient and cost-effective care pathways where appropriate.

• Analyse operational and claims data to identify trends and improvement opportunities.
• Monitor key performance indicators (KPIs) and prepare management reports.
• Support data-driven decision-making through accurate reporting and analysis.
• Assist with fraud, waste, and abuse detection through audits and data reviews.

• Ensure adherence to company procedures, healthcare regulations, and data protection requirements.
• Maintain accurate documentation to support regulatory and legal compliance.
• Support internal audits and continuous improvement initiatives.

• Degree in Healthcare Administration, Business Administration, Nursing, or a related field.
• Previous experience within insurance, healthcare administration, medical claims, TPA services, or a similar environment.
• Familiarity with healthcare systems, medical claims processes, and cost containment practices.
• Strong analytical and problem-solving skills.
• Excellent organisational and multitasking abilities.
• Ability to work independently and manage priorities effectively.
• High attention to detail and accuracy.
• Excellent written and verbal communication skills in English.
• Knowledge of Maltese will be considered an asset.
• Experience with SAP or similar ERP systems will be considered an advantage.

• Strong analytical and strategic mindset.
• Ability to balance operational efficiency with customer and patient outcomes.
• Excellent communication and stakeholder management skills.
• Proactive approach to continuous improvement.
• High level of integrity, professionalism, and confidentiality.

• Office-based or hybrid working environment.
• Collaboration with international teams and stakeholders.
• Occasional flexibility may be required to support operational needs.