Company Name: PT. PRIMA SARANA JASA
Location: Jakarta Selatan
Posted Date: 07/10/2024 11:06
Salary:
Job Description
- WHAT YOU’LL BE DOING
- Analyzes all information pertaining to a claim including medical summaries, medical declarations, policy wording and file specific communications.
- Ensure evidence validation in compliance with client directives.
- Proactively obtain and compile necessary information in order to achieve efficient turnaround time.
- Monitor missing information for escalated claims and intervene, when necessary, involve leadership where applicable.
- Ensures policy wording, medical declaration and intent are applied precisely.
- Prepare clear case summaries for corporate client submission where GEM’s authority thresholds are exceeded.
- Handle appeals, participate in internal and client rounds and provide guidance in active case management.
- Communicate claim progress and coverage issues to claimants.
- Request missing claim components for adjudication.
- Compose denial letters and handle communication regarding claim denials.
- WHO WE ARE LOOKING FOR
- Preferably 1-2 years working experience as a Medical Doctor but Fresh Graduates are welcome to apply.
- Have a degree in Medicine.
- Strong written and spoken English and Bahasa Indonesia.
- Knowledge about Insurance, especially Health will be an advantage.