Healthcare Claims Expert

4 days ago


Jakarta, Jakarta, Indonesia PT Prudential Life Assurance Full time
Job Summary

We are looking for a highly experienced Healthcare Claims Expert to join our team at PT Prudential Life Assurance. The successful candidate will be responsible for examining claims related to hospitalization and non-hospitalization, ensuring they comply with policy provisions and medical necessity.

Main Responsibilities:
  • Examine claims data to determine medical necessity and compliance with policy provisions.
  • Conduct investigations into claims related to hospitalization and treatment of insured individuals.
  • Develop and maintain knowledge of insurance policies and procedures.
  • Collaborate with healthcare providers to resolve claim disputes.

A Medical Doctor degree with a minimum GPA of 3.00, combined with excellent communication and interpersonal skills, is essential for this role.



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