Company Name: PT. PRIMA SARANA JASA
Location: Jakarta Selatan
Posted Date: 11/10/2024 15:46
Salary:
Job Description
- WHAT YOU’LL BE DOING
- Conduct regular audits of claim files to ensure compliance with company guidelines, insurance policies, and regulatory requirements.
- Develop and implement QA procedures for claims processing to ensure accuracy, consistency, and timeliness in the settlement of claims.
- Monitor and evaluate the performance of the claims team through KPIs such as processing accuracy, customer satisfaction, and turnaround time. Provide feedback and training where necessary.
- Ensure all claims processing activities adhere to regulatory standards, mitigating any potential risks through early detection of compliance gaps.
- Analyze QA reports and provide insights to senior management on claims trends, areas of concern, and improvement opportunities.
- Train and mentor the claims team on QA standards, ensuring they are up to date with policies, procedures, and best practices.
- Collaborate with claims adjusters, customer service, and IT teams to streamline the claims handling process and implement new technologies or procedures to enhance efficiency.
- Monitor customer feedback related to claims processes, identify recurring issues, and recommend solutions to improve service quality.
- Work with the claims and customer service teams to investigate and resolve complex claims issues or complaints, ensuring timely and satisfactory resolutions
- WHO WE ARE LOOKING FOR
- 3-5 years of experience in claims handling, quality assurance, or supervision, preferably in a TPA or insurance company.
- Bachelor’s degree in insurance, business administration, or a related field.
- Strong knowledge of claims processing and TPA insurance operations.
- Strong written and spoken English and Bahasa Indonesia.
- Familiarity with local and international insurance regulations and compliance standards.