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.

Key Responsibilities

Administrative Operations

• 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.

Cost Containment & Claims Management

• 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.
• Case Management Support
• 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.

Data Analysis & Reporting

• 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.

Governance & Compliance

• 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.

Requirements

• 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.

What We're Looking For

• 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.

Working Conditions

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

What We Offer

• Competitive remuneration package.
• Hybrid working opportunities.
• Professional development and training opportunities.
• Exposure to international healthcare and insurance operations.
• Opportunity to contribute to meaningful projects that positively impact customer and patient outcomes.

If you are an organised and analytical professional looking to build your career within healthcare and insurance operations, we would love to hear from you. Apply today and become part of a collaborative and growing team.