Case Management Doctor

1 week ago


Jakarta, Indonesia PT Asuransi Allianz Life Indonesia Full time

Provide opinions or decisions for assurance cases in accordance with the authority given

Coordinate with the Allianz and Admedika Medical Hotline related to the first point

Supervise assurance problems that often occur such as bills outside the agreement rate (overcharge), overtreatment actions, changes in medical diagnoses/information, fraud cases, suspicions, PEC, or simple but repetitive cases

Conduct regular meetings with Partner Providers to ensure that the problems in point 3 do not occur

Negotiate with the Associate Provider if there are any unreasonable price increases, overdue matters, or matters outside the agreement

Supervise the performance of Associate Providers regularly and report in writing to the Partner

Prepare or provide daily, weekly, and monthly reports on problems that occur around assurance/treatment to be discussed and sought for preventive measures
Have experience in insurance / TPA field at least 3 years

Education background in Medical

Have insurance knowledge

Have negotiation skill

Good communication and presentation skills



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