Medical Claims Examiner

Analyze hospitalization and non-hospitalization claims based on policy provision and medical necessity, including investigation to hospital and/or treating doctors, if needed.Calculate hospitalization claims based on the provision policy and benefit plan of the insured.Improve product and system knowledge.Conduct proper claim process analysis based on the...

Job SummaryPengiklan Anonim is hiring a Hospital Claim Specialist to analyze hospitalization and non-hospitalization claims based on policy provisions and medical necessity.Key Responsibilities:Analyze claims data to ensure accuracy and compliance with policy guidelines.Investigate claims discrepancies and communicate with providers to resolve...

Head of Claim (Great Eastern Life Indonesia)Job Description:Monitor and ensure claim process within agreed TAT, policies & procedures, and company regulations.Make decision on claim payment within authority limit.Ensure all reports related to claims, including analysis, are submitted within agreed deadlines and claim procedures.Check claim guidelines and...

Head of Claims & Provider RelationsHead of Claims & Provider RelationsApply locations Jakarta Selatan, Jakarta RayaTime type: Full timePosted on: Posted YesterdayJob requisition id: JR00109107You are as unique as your background, experience, and point of view. Here, you'll be encouraged, empowered, and challenged to be your best self. You'll work with...

The Medical Science Liaison serves as an ambassador and an advocate for Pfizer science within the healthcare community. By virtue of his/her training, the MSL is well-positioned to discuss and provide scientific and therapeutic information to Health Care Professionals and Researchers (Medical and Scientific Leaders) viewed by their peers to be authorities in...

About the RolePengiklan Anonim is seeking a Healthcare Policy Analyst to join our team. As a key member of our team, you will analyze hospitalization and non-hospitalization claims based on policy provisions and medical necessity.Key Responsibilities:Analyze claims data to identify trends and areas for improvement.Develop and maintain expertise in healthcare...

About Our TeamPengiklan Anonim is seeking a Benefits Verification Expert to join our team. In this role, you will analyze hospitalization and non-hospitalization claims based on policy provisions and medical necessity.Key Responsibilities:Analyze claims data to identify trends and areas for improvement.Develop and maintain expertise in healthcare policies...

About PT Anugerah Pharmindo Lestari (APL)PT Anugerah Pharmindo Lestari (APL) is a leading healthcare solutions company in Indonesia, providing world-class distribution, commercialization, and clinical trial support to the growing healthcare needs in this region.We have grown to become a major player in the industry, covering 514 cities with over 2,500...

ResponsibilitiesMake short and long term plans related to HR management and HR & GA budgets in the Company, including general services led, which are in line with the company's work plan and conditions.Conduct verification related to employee medical claims and in the company, follow up on payments to ensure the implementation of employee medical claims in...

Get AI-powered advice on this job and more exclusive features.Job Responsibilities:Develop and implement operational strategies to improve efficiency and effectiveness in delivering life and health insurance products and services.Align the operational goals with the overall organizational strategy.Lead process improvement initiatives to streamline workflows...

PT Anugerah Pharmindo Lestari (APL) a Zuellig Pharma company, is a leading healthcare solutions company in Indonesia, and our purpose is to make healthcare more accessible to the communities we serve.We provide world-class distribution, commercialization, and clinical trial support to support the growing healthcare needs in this region. The company was...

Posted a month ago and deadline of application is on 12 AprRecruiter was hiring a day agoOpen to fresh grads HybridResponsibilitiesProcessing request related to quotation and agreement complying with the prevailing procedures and inquiries related to projectMaintain Corporate Secretary databases updated in a timely mannerPrepare Corporate Secretary Quarterly...

About Grab and Our WorkplaceGrab is Southeast Asia's leading superapp. From getting your favourite meals delivered to helping you manage your finances and getting around town hassle-free, we've got your back with everything. In Grab, purpose gives us joy and habits build excellence, while harnessing the power of Technology and AI to deliver the mission of...

Company Description About Grab and Our WorkplaceGrab is Southeast Asia's leading superapp. From getting your favourite meals delivered to helping you manage your finances and getting around town hassle-free, we've got your back with everything. In Grab, purpose gives us joy and habits build excellence, while harnessing the power of Technology and AI to...

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....

Document verification, analyze and entry the claims if the TAT over the target Direct approval as claim processor’s authority limit Send the claim to direct Supervisor (AssMan) to be checked and approved if the authority over staff level Make revision of the claim which have been corrected from their Supervisor Checked and approved claims as SPV's...

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...

Send the claim to direct Supervisor (Manager) to be checked and approved if the authority over staff level Check and approve claims as AssMan's authority limit which delivered from their staff Training and Coaching the team Collaborate with other team to manage complain by responding and follow up every pending case ( KAM, CS, CFBA, Provider) Work...

Hiring Path: - Open to the public Who May Apply/Clarification From the Agency: For USEFM - FP is 07*. Actual FP salary determined by Washington D.C. All Interested Applicants / All Sources Security Clearance Required: Public Trust - Background Investigation Appointment Type Permanent Appointment Type Details: Marketing Statement: We encourage you to...

**_Are you looking for a supportive, collaborative workplace with great teams and inspiring leaders? You’ve come to the right place. We’re looking for ambitious people who share our values and want to make every day better for people around the world. If this sounds like you, and the career below sounds exciting, we’d like to hear from you....

To manage and deliver superior end-to-end Claims Handling activities for respective LOB claims handling in a timely, efficient and effective manner - To manage, identify and improve the detection and prevention of fraudulent claims and all other functional areas - Performing active claims handling from notification until payment and closing of the files -...

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...

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...

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...

**Full Job Description** We are looking for a detail-oriented claims reconciliation specialist to perform above and beyond data entry, and payment posting, verify financial and payer information, as well as patient demographics and research rejections, identify documentation errors, and coordinate correction. Likewise has a strong sense of urgency leading to...

**Responsibility**: - To provide medical inquiries / investigations for insurance claims. - To provide medical advice / recommendation on claim decision. - To provide training related to medical terms. - To provide medical claims analysis for statistical report purpose. **Requirements**: - Doctor ( General Practitioner ), with 24 hours on call...

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...

To provide medical inquiries / investigations for insurance claims. - To provide medical advice / recommendation on claim decision. - To provide training related to medical terms. - To provide medical claims analysis for statistical report purpose. - To maintain relationship with respective clients. - Doctor ( General Practitioner ), with 24 hours on call...

FIND YOUR 'BETTER' AT AIA - We don’t simply believe in being ‘The Best’. We believe in better - because there’s no limit to how far ‘better’ can take us._ - We believe in empowering every one of our people to find their 'better' - in the work they do, the career they build, the life they live and the difference they make. So that together we can...

**OVERALL PURPOSE OF JOB** Responsible for providing our customers with a peerless service experience and claims journey by assessing and processing claims accurately and consistently. With a detailed understanding of the claims lifecycle from receipt to closure, the postholder will provide best-in-class customer service through high-quality correspondence...

| Customer Services & Claims | Entry Level | Non-Executive | Allianz Indonesia | Full-Time | Permanent - Provide claim payment and letters that settlements are made according to company practices and procedures also sufficient file documentation. - Create claim payments and claim letters and upload into claim system **Job Requirements**: - Minimum...

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...

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...

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...