Monitor claim analysis process to make sure it is done accurately and appropriately along with processing claim based on standards sets by the Company.
Reviews and analyzes claims loss.
Verifying and updating information on submitted claims.
Contacting the Hospitals/Clinics and Pharmacies, especially those related to official receipt and billing detail issued by the hospitals/clinics/pharmacies so the claim process can run smoothly and payment made appropriately.
Processing a claim based on standards set by the Company.
Monitor the process of pending and decline claims along with its reasons.
Provide information to Department Head or its Superiors if any suspicious things or does not fit the standards.
Maintenance of records, files, and documentation
Candidate must possess at least a Diploma or Bachelor's Degree majoring in Nursing, Pharmacy / Pharmacology, Public Health or equivalent is preferred.
WILLING TO WORK WITH SHIFTING (If needed)
Experience in related industry (Insurance/TPA) minimum 2 years
Experience in handling claims and administration supports.
Good Command of English (Oral & Written)
Good personality, positive attitude and teamwork.
Computer Literate minimum Microsoft Office ( MS. Word, MS. Excel, Power point ).
Be a part of customer facing projects/programs to guide the customer journey.
Ensuring that all customer communications are free of errors in grammar,â¦
Display basic knowledge or ability to acquire knowledge in the following categories: air conditioning and refrigeration, electrical, mechanical, plumbing,â¦
Work experience in the HSE field min 2 years in manufacture / factory and accustomed to doing internal audits and Involved in the external audit process fromâ¦
Minimum Year of Experience : 4 Year(s).
Monitor and assist activities related to taxation, such as but not limited to the calculation and payment of taxes toâ¦