Insurance Operation Analyst

1 day ago

Jakarta, Jakarta, Indonesia PT Satu Dental Indonesia Full time

Insurance Operation Analyst bertanggung jawab memastikan seluruh proses klaim dan polis asuransi berjalan akurat, valid, dan sesuai standar masing-masing provider. Posisi ini berfokus pada analisis gap saldo/data, validasi dokumen, serta optimisasi prosedur agar klaim dapat diproses 100% sesuai kriteria approval perusahaan asuransi.

Key Responsibilities

  • Melakukan validasi saldo (balance checking) antara data internal dengan laporan asuransi; mengidentifikasi dan menjelaskan alasan perbedaan sebelum klaim diajukan.
  • Menentukan kelengkapan paperwork yang dibutuhkan sesuai standar tiap provider (surat keterangan, form klaim, kuitansi asli, dsb.).
  • Mengarahkan tim agar memilih jenis prosedur yang tepat pada sistem asuransi (misalnya kode tindakan/procedure name sesuai guideline masing-masing provider).
  • Mengkaji format pengisian data (manual vs sistem) dan memberikan rekomendasi agar sesuai preferensi/aturan provider.
  • Mengembangkan checklist klaim untuk memastikan semua dokumen, kode, dan deskripsi sesuai agar approval dapat mencapai 100%.
  • Menjadi subject matter expert dalam membandingkan requirement antar provider (Hanwha vs Fullerton, dsb.), serta menyusun guideline internal.
  • Menyusun laporan analisis klaim yang ditolak (reason of rejection), tren error, dan rekomendasi perbaikan.
  • Berkoordinasi erat dengan provider, broker, dan tim internal (finance/HR) untuk mempercepat penyelesaian klaim.

Qualifications

  • Pendidikan minimal S1 (Manajemen, Asuransi, Akuntansi, atau bidang terkait).
  • Pengalaman 2–4 tahun dalam operasional klaim asuransi/TPA (third party administrator).
  • Memahami detail teknis: balance reconciliation, SLA approval, jenis dokumen legal yang disyaratkan provider.
  • Terbiasa membaca policy wording dan guideline asuransi.
  • Kritis, detail-oriented, dan problem solver.
  • Komunikasi baik dan terbiasa berhubungan dengan banyak stakeholder.

Placement : Head Office (Pluit, Jakarta Utara)

Jenis Pekerjaan: Penuh Waktu

Lokasi:

  • Jakarta (Diutamakan)

Bersedia Melakukan Perjalanan:

  • 25% (Diutamakan)

Lokasi Kerja: Tatap muka

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