claim analyst

Claims Analyst is responsible for reviewing, assessing, and adjudicating health insurance claims in accordance with policy provisions, company guidelines, and regulatory requirements. This role ensures claims are processed accurately, fairly, and within established service standards, while maintaining compliance with internal procedures and risk controls.In...

Claims Analyst is responsible for reviewing, assessing, and adjudicating health insurance claims in accordance with policy provisions, company guidelines, and regulatory requirements. This role ensures claims are processed accurately, fairly, and within established service standards, while maintaining compliance with internal procedures and risk controls.In...

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...

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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...

Melakukan review dan verifikasi dokumen klaim untuk memastikan kelengkapan dan keakuratan dokumen, termasuk mengklasifikasikan dokumen berdasarkan jenis klaim dan layanan, serta mengidentifikasi dokumen yang tidak lengkap atau tidak valid dan melakukan eskalasi jika diperlukan.Melakukan validasi terhadap hasil analisis klaim yang dihasilkan oleh AI dengan...

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...

Analyze and assess health insurance claims in accordance with applicable medical guidelines, provisions, and authorization limits Review claim decisions and provide medical input or recommendations for complex cases, consultations, and special conditions Act as a Medical Advisor in the health insurance claim handling process Approve claim payment requests...

Coordinate with area teams and business partners to handle and resolve operational cases. Conduct investigations to determine appropriate penalties for operational areas that violate SOPs, based on CCTV evidence and supporting data. Conduct detailed CCTV reviews to identify stations that fail to follow standard procedures in package handling. Verify appeal...

DESKRIPSI PEKERJAANJob Description:Analyze and process health insurance reimbursement claims, primarily inpatient claims.Review medical documents, diagnosis, treatment, and claim documents to assess eligibility and accuracy.Validate claims against policy benefits, coverage, exclusions, and applicable terms & conditions.Handle reimbursement claims for both...

Manulife Indonesia is seeking a Medical Helpdesk Support to review and assess medical claims from a clinical perspective, ensuring treatments and hospitalizations comply with medical guidelines and company policies.The role supports pre-approval requests, reviews medical records and supporting documents, and collaborates with hospitals and internal teams to...

Blibli is seeking a Medical Claim Junior Officer to ensure employees receive appropriate healthcare benefits through accurate medical claim assessments. You will interpret diagnoses, evaluate treatments, and coordinate with healthcare providers to resolve issues, contributing to broader employee well-being initiatives.The role requires a strong healthcare...

Manulife está buscando un Analista de Reclamaciones para revisar y adjudicar reclamaciones de seguros de salud, asegurando cumplimiento con políticas y normativas. Trabajará con pacientes, proveedores y brokers para resolver información y mantener la calidad de servicio.La posición requiere título en área sanitaria, experiencia en reclamaciones de...

DESKRIPSI PEKERJAANJob Description:Analyze and process health insurance reimbursement claims, primarily inpatient claims.Review medical documents, diagnosis, treatment, and claim documents to assess eligibility and accuracy.Validate claims against policy benefits, coverage, exclusions, and applicable terms & conditions.Handle reimbursement claims for both...

Prudential Indonesia (PT Prudential Life Assurance) is offering an Apprenticeship - Claim Analyst internship. The role involves calculating hospitalization claims in line with policy and plan details, located in South Jakarta with a hybrid work arrangement (3 days on-site, 2 days remote).Applicants should be final-year or recent graduates in Nursing,...

Claim Analyst Assistant Manager - Jakarta OfficeJob Openings Claim Analyst Assistant Manager - Jakarta OfficeAbout the job Claim Analyst Assistant Manager - Jakarta OfficeRequirements;Have experience in technical claims handlingAnalytical approach, diligent and accurate working style, flair for numbers, excellent attention to detailVerify the necessity and...

Talent by Marlin mencari Customer Service di Yogyakarta untuk menangani klaim asuransi kesehatan dan verifikasi dokumen terkait dengan dukungan AI. Tugas utama meliputi validasi klaim, menjaga akurasi data, serta mendeteksi potensi fraud dengan SOP/SLA yang berlaku.Posisi ini full-time dengan pekerjaan tatap muka di lokasi Yogyakarta; kandidat diharapkan...

PT Radita Hutama Internusa, part of Charles Taylor Adjusting Companies, seeks an Average Adjuster to investigate marine insurance claims from Jakarta-based offices. The role emphasizes on-desk investigations of maritime casualties and establishing liability under policy terms, with on-site attendance when required.The candidate should hold a Bachelor’s in...

MAG Insurance in Jakarta is seeking a Claims Analyst to receive, review, and analyze non-motor claim documents across Property, Engineering, and Liability classes, excluding Marine. You will verify document completeness, assess loss causes, determine claim validity, and prepare analysis reports with recommendations for payment or further...

Pengiklan Anonim is seeking an Insurance Operation Analyst to support insurance operations, ensuring accurate claim documentation and timely processing. You will coordinate with insurance providers and internal teams while maintaining compliance with policies and procedures.The role requires attention to detail, analytical thinking, and strong administrative...