Health Claim Operation Analyst Jobs

Berpengalaman min. 1-2 tahun di bidang pengelolaan polis/ pernah bekerja di perusahaan asuransi

Memiliki kemampuan interpersonal yang baik

Memiliki kemampuan bekerja sama dalam tim

Berpengalaman dalam penggunaan aplikasi pengelolaan data (min. excel advanced level)

Contribute to the development of knowledge management systems

Support sub-national actors in decentralized settings by strengthening capacity to respond to increased autonomy for planning, budgeting and public financial management.

Support ministries of health and finance on development of national health financing strategies, budget planning, preparation and execution, and budget advocacy.

Lead analyses on health expenditure, including out-of-pocket spending, financial forecasting, benefit incidence analysis, resource tracking and cost-effectiveness.

Develop and manage large datasets such as NHA, IDHS, SUSENAS, and BPJS-K claims. This includes cleaning, constructing, sorting, and updating variables.

BA/BS (Econ) and 7+ years experience or graduate degree and 5+ years experience;

Preferably have a good understanding about clinic management

Preferably a doctor with Occupational Specialist Certification

Able to work as a team and manage a team

Adequate work facilities when working from home

Encourage and implement innovations in process dan new services

Candidate must possess at least a Medical Degree (Sarjana Kedokteran)

Experience in Logistic Transportation/ Shipping Company

Detail oriented, analytical thinking, and proven superior communication skills

Monitor liability claims from start to finish.

Analyze, monitor, verify, and update information on submitted claims and review the policy.

Minimum Bachelor's Degree in Mechanical Engineering

Dynamic team player, self-motivated and pleasant personality

Checking document completeness and validity of non-hospitalization claims

Analyze and provide decision non-hospitalization claims.

Provide letter regarding claim decision.

Provide summary for reassurance referral.

Coordinate with other team to communicate with customer and resolve customer complaints.

Ad-hoc project regarding non-hospitalization claim.

Good medical knowledge and analytical thinking.

Minimum 1 year experience as Medical Opinion in lif insurance industry.

Responsible for analyzing medical claim, in accordance with limit approval level and claim procedure.

Ensure claim assessment is made accurately, consistent and fair.

Provide evaluation and medical opinion.

Settle medical claim process and do required coordination in order to support claim process settlement.

Have an experience in the field of life insurance

Minimum 2 years experiences in Life Insurance/HR Consultant

Analyze health business conditions, propose, and implement the improvement based on the business conditions and digital trend

Advice, evaluate, and implement health business development

Develop, execute, and lead the development of Health Business projects

Propose and implement programs/activities/content on the Medcare application

Bachelor’s degree with good knowledge of General Insurance principal, Minimum 2 years of relevant experience fresh graduates are welcome to apply.

Cooperate with other departments needed such as: Underwriting Dept., Finance Dept., Legal Dept., Compliance Dept., etc.

Have a good knowledge of the system, claim process, Insurance Principal, and policy provision.

Good leadership and decision-making skills

Ensure the End-to-End claim process with good quality and valid as per SeaInsure policy provision.

Monitoring performance claim process internally by creating solutions to minimize repetitive errors or any delayed process.

Have a Mining Safety Management System (SMKP) Auditor - MINERBA Registered is desirable

The background, education, and work experience needed to succeed in this job are:

Core Competencies (Knowledge, Skills & Characters)

5+ years experience in Health & Safety related experience in mining, mineral/metal processing especially in Health & Safety operation

Have a valid Frontline Operational Supervisor (POP) - BNSP certification.

Have a valid Occupational Health & Safety Expert (AK3U) - BNSP or DISNAKER certification

Maintaining document and record related to Occupational Health Management and providing regular reporting to all related stakeholders.

The background, education, and work experience needed to succeed in this job are:

Core Competencies (Knowledge, Skills & Characters)

5+ years experience in Health & Safety related experience in mining, mineral/metal processing especially in Occupational Health field

Have a valid Frontline Operational Supervisor (POP) - BNSP certification.

Have a valid Occupational Health & Safety Expert (AK3U) - BNSP or DISNAKER certification

Bachelor degree with good knowledge in Insurance principal and medical

Minimum 3 years of relevant experience

Have a good knowledge in system, claim process, Insurance Principal and AIA policy provision

Good leadership and decision making skill

AIA currently is hiring for Claim Analyst role with below details responsibilities & role:

Ensure End to End Major claim process have good quality and valid as our policy provision.

In-depth knowledge of the industry standards, regulations related, and insurance reporting

Excellent skill in Ms. Office and Ms. Access

Final year student of Actuary, Mathematic, or Statistics with min GPA 3.00

Fresh graduate are encouraged to apply

Certified in AAAIJ/AAIJ/ASAI/FSAI is an advantage

Understand and have extensive knowledge in the health and digital fields or in related fields

Accustomed to working with or understanding Mekari Talenta and Human Resources (HR) & employee benefits applications

Minimum 2 years experience in the related field

Analyze health business conditions, propose, and implement the improvement based on the business conditions and digital trend

Advice, evaluate, and implement health business development

Develop, execute, and lead the development of Health Business projects

Bachelor degree with good knowledge in Insurance principal and medical

Minimum 3 years of relevant experience

Have a good knowledge in system, claim process, Insurance Principal and AIA policy provision

Good leadership and decision making skill

AIA currently is hiring for Claim Analyst role with below details responsibilities & role:

Ensure End to End Major claim process have good quality and valid as our policy provision.

Have experience 1 - 2 years in health insurance or health service provider (hospital/clinic)

Good communication and personal skill

Effective verbal and written communication skills

Strong multi-tasking and prioritization skills

Experience collaborating in a team environment and building cross functional working relationships

Bachelor’s Degree of Medicine, preferably with a medical degree