Claim Management Staff Jobs

Halodoc is the pioneer of a digital health ecosystem with a mission to simplify access to healthcare, by answering the various needs and pain points of users. The company is also committed to keeping people healthy through preventive to curative health approaches that can be accessed in one application.

Since 2016, the Halodoc ecosystem has continued to grow with diverse services, making it easier for people to access health services, starting from Home Lab - preventive care that allows users to carry out health tests safely and comfortably from home privately; My Insurance that enables users to access the benefits of cashless outpatient services in a more seamless way; Chat with Doctor which allows users to interact with 20,000+ licensed doctors and health workers via chat, video call or voice call; as well as Health Store that provides access for users to buy medicines, supplements, and other health products from 4,900+ trusted partner pharmacies.

Halodoc is chosen as one of 15 telehealth that has received “supervised” status and is included in the regulatory sandbox program, making Halodoc to be Indonesian Ministry of Health’s partner and granting us participatory supervision from MoH for the protection of consumers and health workers as users of digital innovations. Halodoc has racked up a string of prestigious awards at the scale of national and international, such as: selected to be the only Southeast Asian health technology start-up to feature on CB Insights' Digital Health 150 list in 2019-2020 and given the Indonesian government's 2023 PPKM Award.The Halodoc application is available for download via iOS and Android.

We have Case Management Staff that offer an exciting opportunity for you to take on new challenges and grow with us!

Responsibilities

• Monitoring online transactions (claim) which haven’t send to Halodoc by a healthcare provider and do the follow-up on a weekly basis.
• Accountable on daily operations to meet productivity or service standards as defined by management in line with department and/or division.
• Manage and resolve complaints and escalate to supervisor/manager if needed.
• Responsible for daily case management and daily inpatient monitoring for a medical condition and expenses and identified cases to be escalated to supervisor/manager/ Medical Advisor.
• Complete all daily call log and daily inpatient monitoring log.
• Managed time for work on shifts, guided by the manager on 24/7 service deliverable.
• Answer calls and handle any queries from the health care provider, insurance/payer, and patient.
• Guarantee issuance and online claim assessment.

Qualifications

• Computer literate.
• Good communication skills.
• Willing to working on shifting hours and public holiday.
• Excellent knowledge of health insurance policy, health claims procedures, and terminology.
• Minimum qualification diploma (Nursing or other medical-related fields).
• 2 years working experience in healthcare, insurance, TPA, or related fields.
• Excellent knowledge of medical terminologies especially for treatment and surgeries or insurance.