Deskripsi Pekerjaan
Join Global Excel as a Senior Case Assessor and become a critical part of our insurance claims resolution process. In this impactful role, you'll evaluate complex insurance claims with precision, ensuring adherence to policy guidelines while maintaining exceptional customer service standards. You'll collaborate with healthcare providers, policyholders, and internal stakeholders to investigate claim details, verify documentation, and determine fair outcomes—all while communicating clearly in English. This position offers the opportunity to drive operational excellence through data-driven insights and continuous process improvements.
As a Senior Case Assessor, you'll navigate challenging scenarios with professionalism and analytical rigor. Your expertise will directly influence customer satisfaction and organizational efficiency, making this ideal for detail-oriented professionals with a passion for healthcare compliance and risk management. If you thrive in dynamic environments where your decisions have tangible impact, Global Excel provides the perfect platform to advance your career in insurance assessment.
Tanggung Jawab
- Evaluate and process insurance claims with meticulous attention to detail and policy compliance
- Investigate claim documentation and medical records to determine validity and coverage
- Communicate claim outcomes and requirements clearly to stakeholders in English
- Collaborate with healthcare providers and adjusters to resolve discrepancies
- Identify trends in claims data and recommend process improvements
- Maintain accurate claim records and documentation in compliance with regulations
- Escalate complex cases to senior management with detailed analysis and recommendations
Kualifikasi
- Bachelor's degree in Healthcare Administration, Business, or related field
- Minimum 3 years of experience in insurance claims processing or medical assessment
- Proven ability to analyze complex medical documentation and insurance policies
- Fluent written and verbal communication skills in English
- Strong analytical skills with attention to detail and problem-solving abilities
- Familiarity with Indonesian healthcare regulations and insurance compliance standards
- Proficiency in claims management software and MS Office applications