Medical Doctor (English Speaker)
Salary undisclosed
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What You'll Be Doing
- Attend transmission and attend Case Quality Review in Operation Excellence every working day and duty day and give case directly to the best of his/her knowledge
- Assist daily activity in Operation Excellence Department in obtaining sufficient medical reports from the medical providers to move the case forward.
- Assist daily activity in Operation Excellence Department to ensure reviewing medical reports from the medical providers are done in timely manner to full fill the Turn Around Time (TAT)
- Assist daily activity in Operation Excellence Department in providing recommended medical providers for the clients.
- Assist daily activity in Operation Excellence Department to negotiate with the medical provider for the best pricing, corporate price, or discount and to review the hospital billings whenever is required
- Manage and supervise Medical Claim Excellence staff in managing the case properly and in the line with the standard operations policy and procedure.
- Have a good relationship with the medical providers and to ensure that the medical providers will provide the best quality of healthcare rendered by our clients.
- Conduct billing audits of all received invoices prior to any payment done in order to get the best review of medical claims.
- Ensure all information related with the case activities are well documented in the system.
- Ensure that all close case/claims have the ICD-10 been verified in the system.
- Handle any complaints raised by clients or service provider towards Operation Excellence Department.
- Escalate to Medical Claim Excellence’s Assistant Manager if the complaint is serious and need further follow up to mitigate service recovery.
- accountable to assist other department and crisis management center for a special task or mission.
- Maintain a good working environment, develop good teamwork among the colleagues and staff by maintaining good communication.
- Ensure that all procedure, policy and company information is maintained to the latest date issued in accordance with the Quality Control and Continuous Improvement of Company policy.
- Establish a collaborative and co-operative relationship among the staff, to create a conducive working environment and conditions. To foster the motivation of the staff to work at optimal efficiency.
- Preferably 1-3 years working experience as a Medical Doctor but Fresh Graduates are welcome to apply.
- Degree in Medicine.
- Having knowledge in Insurance, especially Health.
- Possess service-centered mindset.
- Strong written and spoken English and Bahasa Indonesia
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