Sr. Claim Reimbursement Analyst Executive (Great Eastern Life Indonesia)

Job Summary

To Analysis all type of claim (Death, Hospitalization, Outpatient, Dental, Maternity) include to investigate or confirmation the claim cases.

Job Description:

• Reviewing insurance claims filed by policyholders to ensure they are accurate and complete, that the individual understands their benefits, and that the policies cover the claims.
• To analyze and verify claim within agreed TAT.
• To make decision claim payment within authority limit.
• To investigate suspicious claim by letter and phone to hospital or clinic.
• Handling the queries and complaint from related parties, policy holder, agent/seller, call center, Third Party Administrators.
• Confirming medical claim cases from Third Party Administrators outside working hours.
• Assisting other Departments (underwriting and credit life) in checking a customer's medical history and assisting with medical consultations for potential new customers.
• Assist in checking decision letters to customers (both pending and rejecting notes) and checking detailed payment tables to customers.

Requirements:

• Degree in Medical major.
• Minimum 5-year experience in claim analyst reimbursement in life insurance
• Having network in local claim community
• Expert in SQL, Microsoft Excel, data visualization and dashboarding.
• Good communication skills both verbally and in writing required.