Claims Analyst

3 hours ago


Jakarta, Indonesia Inova Care International Full time

Claim Analyst Staff

Qualifications:
Male/ Female

Minimum 1-year experience as a Claim Analyst in Insurance/ TPA company

Excellent knowledge health insurance policy, health claims procedures and terminology

Excellent knowledge on medical terminologies

Strong analytical and inter-personal skill

Good problem-solving skill

Proficient in Ms. Office

Responsible, ability to work individually as well as with a team

Good interpersonal, communication, attitude and positive

**Responsibilities**:

- Make medical necessity and medical appropriateness determinations for health and dental claims.
- Determine benefit liabilities based on medical necessity, benefit level, member eligibility, waiting periods, pre-existing conditions, exclusions and coverage.
- Ensure all claims are properly documented and conform to company’s workflow and documentation requirements.
- Ensure claims are associated with and comply with any prior-authorization or authorization requirement.
- Coordinate with the medical review team for questions regarding medical necessity and medical appropriateness.
- Research and resolve misapplied claim payments or provider reimbursements.
- Ensure claims are properly coded and documented before processing.
- Document and report potentially fraudulent provider and member claims to immediate supervisor or manager.
- Submit all approved and processed claims to finance team for liquidation.
- Issue EOB (explanation of benefits) to all members as well as EOP (explanation of provider payments) to all network providers.
- Complete all daily, weekly, monthly, quarterly and annual management reporting requirements for the scope of responsibilities associated with your position.
- Communication to providers and members for partially denied, incomplete or denied claims.
- Ensuring all company service level standards are met as it relates to claims analysis and examination.
- Other tasks assigned by management in support of the company’s claims management objectives

**Benefits**:

- Salary IDR4,900,000
- BPJS Ketenagakerjaan
- BPJS Kesehatan
- Religious Bonus

Pay: Rp4,000,000 - Rp4,900,000 per month

Ability to commute/relocate:

- Jakarta: Reliably commute or planning to relocate before starting work (required)


  • Analyst Claim

    4 days ago


    Jakarta, Indonesia PT.PROVIS GARUDA SERVICES Full time

    Kualifikasi: - Pria / Wanita - Usia maksimal 35 tahun - Pendidikan mínimal D3 Perawat / Kesehatan Masyarakat / Kebidanan - Memiliki pengalaman min.1 tahun sebagai Claim Analyst di perusahaan asuransi - Domisili di Jakarta dan sekitarnya **Education**: - D1-D4 (required) **Experience**: - Claim Analyst: 1 year (required)

  • Claim Analyst

    4 days ago


    Jakarta, Indonesia PT.PROVIS GARUDA SERVICES Full time

    Kualifikasi: - Pria / Wanita - Usia maksimal 35 tahun - Pendidikan mínimal D3 Perawat / Bidan / Kesehatan Masyarakat - Memiliki pengalaman sebagai Claim Analyst min.1 tahun di Asuransi - Bersedia dengan sistem target - Domisili di Jakarta dan sekitarnya Jenis Pekerjaan: Penuh Waktu Gaji: Dari Rp4.900.000 per bulan Pendidikan: - D1-D4...

  • Claims Analyst

    18 hours ago


    Jakarta, Indonesia Chubb INA Holdings Inc. Full time

    Job Requirements Position Summary Supervise the claims assessment processing and provides consultation for claims assessors for individual product Roles & Responsibilities Responsible for the claim servicing on a standardized range (SLA, TAT, claims payment, error rate, etc) Monitoring and supervise the day to day claims process in Claims department. Inter...

  • Claim Analyst

    7 months ago


    Jakarta, Indonesia Prudential plc Full time

    Prudential’s purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured, for our people, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and we support...

  • Claim Analyst

    7 months ago


    Jakarta, Indonesia Sunday Insurance Full time

    **_Claim Analyst_** **_As a Claim Analyst_** each day, you'll be...** - Analyzing reimbursement claims utilizing our claim express service, adhering to a 2 x 24 hour processing timeline. - Accurately inputting claim data into our system for record keeping and analysis. - Monitoring daily claims to guarantee timely processing and resolution. - Collaborating...

  • Claim Analyst

    18 hours ago


    Jakarta, Indonesia Provis Garuda Services PT Full time

    Pria / Wanita - Usia maksimal 35 tahun - Pendidikan min.D3 Perawat - Memiliki pengalaman sebagai Claim Analyst di Asuransi min. 1 tahun - Bersedia untuk lembur - Lokasi kerja di Jakarta Selatan

  • Claim Analyst

    7 months ago


    Jakarta, Indonesia Healthpro.id Full time

    **Kriteria**: - Min pendidikan D3 (Keperawatan, Kebidanan, Farmasi, atau bidang terkait) - Min pengalaman kerja 1-2 tahun dibidang yang kesehatan, asuransi, dan TPA - Memiliki pengetahuan yang baik terkait terminologi kesehatan, kebijakan asuransi kesehatan, prosedur claim kesehatan - Mahir dalam penggunaan komputer - Keterampilan komunikasi yang...

  • Claim Analyst

    7 months ago


    Jakarta, Indonesia PT Provis Garuda Services Full time

    Persyaratan Pria/ Wanita Usia Maksimal 35 Tahun WAJIB Pendidikan Minimal D3 Kebidanan/ Keperawatan Berpengalaman di Posisi yang Sama Minimal 1 Tahun Terbiasa Bekerja Dalam Target Tepat Dalam Memberikan Diagnosa Medis Memahani Alur Kerja Sebagai Claim Analyst Dapat Bergabung Secepatnya Bersedia Ditempatkan di Sudirman Jakarta Selatan

  • Claim Analyst

    7 months ago


    Jakarta, Indonesia Asia Outsourcing Services Full time

    Klien kami sebuah Perusahaan Asuransi terkemuka di Indonesia saat ini sedang membuka lowongan untuk posisi: CLAIM ANALYST Penempatan : Jakarta Pusat Job deskripsi: - Melakukan analis terhadap polis asuransi Kualifikasi: - Pria / Wanita - Min D3 Paramedis (keperawatan/kebidanan/kesehatan masyarakat) - Usia Max 35 tahun - Pengalaman bekerja sebagai analis...


  • Jakarta, Indonesia Asia Outsourcing Services Full time

    Klien kami sebuah Perusahaan Asuransi terkemuka di Indonesia saat ini sedang membuka lowongan untuk posisi: DATA ENTRY CLAIM ANALYST Penempatan : Jakarta Selatan Job deskripsi: - Melakukan input dan analisa document claim seperti surat keterangan dokter, bill rumah sakit dan lain-lain terkait dengan document claim Kualifikasi: - Pria / Wanita -...

  • Claim Analyst

    7 months ago


    Jakarta, Indonesia FUSE Full time

    We are currently building the #1 Insurtech in Southeast Asia that helps people to reach insurance in the most efficient way. Therefore we need talent with great potential like you to join this growing organization, learning the right skills and also building great teams to reach our goals. **Responsibilities** - Providing advice and analyzing on a claim...


  • Jakarta, Indonesia Prudential Full time

    Prudential's purpose is to help people get the most out of life. We will deliver our purpose by creating a culture in which diversity is celebrated and inclusion assured, for our colleagues, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and in exchange, we support our people's career...


  • Jakarta, Indonesia FWD Insurance Full time

    PT FWD Insurance Indonesia (“FWD Insurance”), a joint-venture insurance company and a part of FWD Group, previously known as PT Commonwealth Life, has successfully merged with PT FWD Life Indonesia (“FWD Life”) as of 1 December 2020 and will be known as FWD Insurance. The merger of FWD Life and FWD Insurance has led to a more comprehensive range of...

  • Claim Analyst

    7 months ago


    Jakarta, Indonesia PT Provis Garuda Services Full time

    **Informasi Lowongan** **Tipe Pekerjaan** **Remote/On-site** **Fungsi Pekerjaan** Bagian Klaim **Jenjang Karir** Staf Senior **Job Deskripsi** - Berpengalaman Sebagai Claim Analyst Minimal Satu Tahun **Persyaratan** **Tingkat Pendidikan** S1 **Jurusan Pendidikan** Bidan, Perawat **Minimal Pengalaman** 1 tahun **Deskripsi Persyaratan** - Pria/...


  • Jakarta, Indonesia Asia Outsourcing Services Full time

    Klien kami sebuah Perusahaan Asuransi terkemuka di Indonesia saat ini sedang membuka lowongan untuk posisi: DATA ENTRY CLAIM ANALYST Penempatan : Jakarta Selatan Job deskripsi: - Melakukan input dan analisa document claim seperti surat keterangan dokter, bill rumah sakit dan lain-lain terkait dengan document claim Kualifikasi: - Pria / Wanita -...

  • Claims Analyst

    8 months ago


    Jakarta, Indonesia Across Asia Assist Indonesia Full time

    Analyze insurance / Corporates claims to ensure accuracy, completeness, and adherence to policy terms and conditions - Verify all supporting documentation submitted with claims, ensuring it meets the required standards and policies - Utilize analytical tools and methodologies to detect potentially fraudulent activities or discrepancies in claim submissions -...

  • Claim Associate

    4 days ago


    Jakarta, Indonesia Qoala Full time

    Qoala is the biggest omnichannel InsurTech company in Southeast Asia, with a purpose to democratize, empower and redefine insurance for customers.Currently operating in Indonesia, Malaysia, Vietnam and Thailand, Qoala is South East Asia’s largest insurance technology startup who provides an affordable, and personalized insurance protection just at your...

  • Claim Analyst

    4 days ago


    Jakarta, Indonesia PT Bahtera Pesat Lintasbuana Full time

    Persyaratan - Pria dan Wanita usia maks 35 tahun - Lulusan min D3 dari Perawat / Kebidanan - Pengalaman claim analis - Penempatan di Sudirman - Jakarta Tanggung Jawab - Registering & analyzing (hospitalization and non hospitalization claim) based on target set for each claim categorization. - Making claim letter for claim paid and decline. - Maintenance &...


  • Jakarta, Indonesia FWD Insurance Full time

    PT FWD Insurance Indonesia (“FWD Insurance”), a joint-venture insurance company and a part of FWD Group, previously known as PT Commonwealth Life, has successfully merged with PT FWD Life Indonesia (“FWD Life”) as of 1 December 2020 and will be known as FWD Insurance. The merger of FWD Life and FWD Insurance has led to a more comprehensive range of...

  • Claim Analyst

    4 weeks ago


    Jakarta, Indonesia AIA Full time

    At AIA we’ve started an exciting movement to create a healthier, more sustainable future for everyone. - It’s about finding new ways to not only better people's lives, but to better the communities and environments we live in. Encompassing our ambition of helping a billion people live Healthier, Longer, Better Lives by 2030._ - And to get there, we need...