Health Claim Operation Analyst

7 months ago

Jakarta, Indonesia Zurich Insurance Full time

Job Summary- To handle single and multi-party personal or commercial line claims of moderate to high exposure and complexity within specific authority limits, to ensure that claims are handled in the most efficient, effective way while delivering a customer-centric claims service.- Job Qualifications- Required:
- Bachelor’s Degree of Medicine, preferably with a medical degree
- Have experience 1 - 2 years in health insurance or health service provider (hospital/clinic)
- Having good clinical analysis, pharmacology
- Having good understanding with health insurance policy contract
- Good communication and personal skill

Preferred:
- Effective verbal and written communication skills
- Strong multi-tasking and prioritization skills
- Experience collaborating in a team environment and building cross functional working relationships
- Proactively shares and promotes sharing of insights
- Ability to gather unique perspectives from other teams/functions to optimize outcomes.
- Understands, analyzes, and applies the component parts of an insurance policy for complex claims
- Ability to follow reserving process for indemnity and expense in analyzing the potential exposure of complex claims
- Ability to determine the scope and exposure for complex claims
- Ability to leverage trend and relationships to provide high-quality customer service
- Well-versed in identifying, understanding and explaining complex financial and/or actuarial trends/concepts.
- Ability to effectively communicate coverage determinations to customers/clients/brokers for complex claims
- Ability to direct counsel on an ongoing basis to guide the course of complex litigation and settlement strategies
- Job Accountabilities - Key Accountabilities- Document claims file by accurately capturing and updating claims data/information in compliance with best practices for single and multi-party personal or commercial line claims of moderate to high exposure and complexity.
- Exercise judgment to determine liability by gathering and analyzing relevant facts; utilizing applicable law; establishing basic principles of negligence.
- Exercise judgment to determine policy verification and coverage determination by analyzing applicable coverage for claims and determining whether the loss falls within the coverage.
- Work to have a timely resolution to claims by developing case strategy; developing a case evaluation; escalating issues as appropriate.
- Establish timely reserves and perform ongoing review throughout claims cycle within authority limit by estimating and validating value of claims.
- Assess damages by calculating applicable damages or range of damages allowed by law.
- Negotiate settlement of claim by establishing appropriate negotiation strategy and utilizing available tools and resources within authority limits.
- Meet quality standards by following best practices

A future with Zurich

Now is the time to move forward and make a difference. At Zurich, we want you to share your unique perspectives, experiences and ideas so we can grow and drive sustainable change together. As part of a leading global organization, Zurich North America has over 148 years of experience managing risk and supporting resilience. We are a leading provider of commercial property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. Today, we serve more than 25 industries, from agriculture to technology and insure 90% of the Fortune 500®. Our growth strategy is not limited to our business. As an employer, Zurich strives to provide ongoing career development opportunities and foster an environment where voices are diverse, behaviors are inclusive, actions drive equity, and our people feel a sense of belonging. Be a part of the next evolution of the insurance industry. Join us in building a brighter future for our people, our customers and the communities we serve.

As a global company, Zurich recognizes the diversity of our workforce as an asset. We recruit talented people from a variety of backgrounds with unique perspectives that are truly welcome here. Taken together, diversity and inclusion bring us closer to our common goal: exceeding our customers’ expectations. Zurich is committed to providing a diverse, inclusive and barrier-free environment resulting in an accessible organization for employees, customers, and other parties who interact with, or on behalf of, Zurich. We strive to achieve a workplace free of discrimination of all forms, including discrimination on the basis of physical or mental disability, or medical condition. If you are interested in a job opportunity, please advise if you require an accommodation, so we can work with you to provide a more accessible process.

Zurich does not accept unsolicited resumes from search firms or employment agencies. Any unsolicited resume will become the property of Zurich Canadian Holdings Limited. If you are a preferred vendor, please use our Recruit

  • 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...

  • Analyst Claim

    2 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 Associate

    2 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

    2 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...

  • Claim Operation

    6 months ago

    Jakarta, Indonesia Marsh Full time

    **Claim Operation - Employee, Health & Benefit** **What can you expect?** Provide support to Client Facing Brokers in all aspects of claim and administration: As first contact response of client and responsible for day-to-day operational claim service, for claim administration, claim inquiry, guarantee coverage & claim cases arise. Not forget to mention to...

  • 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...

  • Supervisor Claim Analyst

    6 months ago

    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 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...

  • Claims & Health Analytic Manager

    2 months ago

    Jakarta, Indonesia Aon Corporation Full time

    Posting Description: **Claims & Health Analytic Manager**: We're hiring! We are looking for a Claims and Health Analytic Manager to join our team in Jarkata, Indonesia. **Aon is in the business of better decisions**: At Aon, we shape decisions for the better to protect and enrich the lives of people around the world. As an organization, we are united...

  • 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 Health Officer

    9 months ago

    Jakarta, Indonesia LippoInsurance Full time

    **Responsibilities**: - Responsble for handling customer claims in health insurance area **Requirements**: - At least a Diploma degree in Nursing. Fresh-graduates are welcome to apply - Able to do medical analysis and diagnosis in nurse level - Familiar with Microsoft Office (Microsoft Word and Excel) - Have good communication skills, both in bahasa...

  • 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...

  • Claim Individu Life

    6 months ago

    Jakarta, Indonesia AJ Central Asia Raya Full time

    **Kualifikasi**: - Kandidat setidaknya memiliki Gelar Profesi Dokter. - Setidaknya memiliki 3 tahun pengalaman di bidang Claim Individu Life & Health di Perusahaan Asuransi Jiwa - Memiliki kemampuan analisa yang baik, komunikasi yang baik dan inisiatif - Memiliki kemampuan Leadership yang baik. - Menguasai Microsoft Office. **Deskripsi Pekerjaan**: -...

  • Data Entry Claim Analyst

    2 days ago

    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...

  • Apprenticeship - Group Claim Service

    6 days ago

    Jakarta, Indonesia Prudential plc 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...

  • Apprenticeship - Group Claim Service

    4 days ago

    Jakarta, Indonesia Prudential plc 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...

  • Claims Analyst Non Tpa Supervisor

    1 week ago

    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/...

  • Executive - Claim Analyst

    8 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...