Medical Claim Manager

Job Summary:We are looking for a dedicated and experienced Medical Claims Supervisor to manage and oversee the daily operations of the medical claims team for one of our esteemed clients, an insurance company. The successful candidate will be responsible for supervising the claims processing workflow, ensuring that all claims are managed efficiently,...

Responsibilities:Analyze hospitalization and non-hospitalization claim based on policy provision and medical necessity, including investigation to hospital and/or treating doctors, if neededCalculating the hospitalization claim based on the provision policy and benefit plan of the insured.Improvement of product and system knowledgeDo proper claim process...

As Head of Claim EB each day, you'll be…Manage the end-to-end claims operations including inpatient, outpatient, and dental claims.Develop and implement claims policies, procedures, and service standards in line with company objectives and OJK regulations.Ensure timely, accurate, and compliant claims settlement in accordance with policy terms and...

WHAT YOU'LL BE DOINGAttend transmission and attend Case Quality Review in Operation Excellence every working day and duty day and give case directly to the best of his/her knowledge.Assist daily activity in the Operation Excellence Department in obtaining sufficient medical reports from the medical providers to move the case forward.Assist daily activity in...

As Medical Advisor each day, you'll be…Case management of complex high value cases Recommendation on claim decision Medical claim analysis for Statistical report purposeAggressive cost containment through tight adjudicationRequirements: Doctor (General Practitioner), with 24 hours on call availability Have experience in Insurance, or Assistance Company...

Job DescriptionDevelop and implement a strategic vision for the life insurance claims department in alignment with the company's overall goalsOversee the entire life insurance claims process, from the initial claim notification to final settlement.Ensure compliance with regulatory requirements, company policies, and industry standards.Implement and update...

Responsible for the process of risk claims, including individual, group and provider claims and provide claim decisions according to the value of the Authorization. As well as reporting and analyzing the impact on the companyCoordinating process governance, decision making and reporting of risk claims, ensuring that the Company has carried out its risk claim...

Job Descriptions :Create product demand for medical devices (consumables)Getting revenue from product performanceExecuting marketing strategies and build customer relationshipsJob Requirements :Minimum Bachelor's Degree, any majorMinimum2 yearsof working experience as a Medical RepresentativePossess sales and negotiation skills, presentation skills, and...

The Medical Manager (TA) is responsible for ensuring consistency, quality, and compliance in execution of medical-to-medical initiatives and stakeholder-centric engagement, in relation to field-based medical activities. The Medical Manager (TA) supports the training and development of internal medical team, BU team including the development of external...

Summary Of The JobThe role encompasses the comprehensive management of the end-to-end claims process, which includes effective communication with various stakeholders, meticulous document handling, system registration, and the escalation of issues to the relevant team members. This position specifically supports the Qoala Gadget Protection and Qoala for...