Claim Analyst Reimbursement Senior
Experience Staff
Full-Time
Working Mode : WFO
Not Displayed
Tanggung Jawab Pekerjaan
- Analyze and process health insurance reimbursement claims, primarily inpatient claims.
- Review medical documents, diagnosis, treatment, and claim documents to assess eligibility and accuracy.
- Validate claims against policy benefits, coverage, exclusions, and applicable terms & conditions.
- Handle reimbursement claims for both corporate and individual members.
- Manage and resolve complex claim cases, including discrepancies and potential irregularities.
- Coordinate with members, corporate PICs, healthcare providers, agents, and internal teams when required.
- Ensure accurate and timely claim processing in accordance with SLA/TAT and company procedures.
- Support claim billing, reporting, and documentation processes.
- Identify opportunities for claim process improvement and provide recommendations.
Kualifikasi
- Minimum Bachelor's degree in Nursing.
- Minimum 3 years of experience in Health/Reimbursement Claims, preferably with inpatient reimbursement experience.
- Strong understanding of medical documents, claim analysis, and policy benefits.
- Strong analytical, problem-solving, communication, and attention-to-detail skills.
- Able to work independently and collaborate effectively with multiple stakeholders.
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Lamar
Claim Analyst Reimbursement Senior
DKI Jakarta, Kota Jakarta Selatan
DKI Jakarta, Kota Jakarta Selatan
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