Case Monitoring - Cakung, Jakarta

Job summary

We are actively developing Southeast Asia's top TPA, which makes it easier for consumers to obtain insurance. To achieve our objectives, we therefore require talent with great potential, like you, to join our expanding organization, acquire the necessary skills, and also form outstanding teams.

Responsibilities

• Provide expert medical advice and consultation to internal teams and external clients.
• Conduct comprehensive reviews and analyses of medical data, claims, and utilization patterns.
• Collaborate with healthcare providers to ensure appropriate care delivery and utilization management.
• Develop and deliver educational materials and presentations on medical and healthcare topics.
• Assist in the evaluation and selection of healthcare networks and providers.

Qualifications

• Ready to Shifting
• Bachelor's degree in Nursing, Pharmacy, Public Health, or other healthcare-related fields (medical background preferred).
• Strong understanding of healthcare and insurance claims processes, with experience in claims management or case monitoring.
• Excellent analytical and problem-solving skills, especially in resolving claim disputes.
• Effective communication and collaboration skills for working with internal teams and external healthcare providers.
• High attention to detail, professionalism, and ability to manage multiple cases under tight deadlines.

Deskripsi pekerjaan