Case Management Executive

HealthMetrics; Jakarta Selatan; On-site; IDR 89,280,000 - 156,240,000; Full time

Job summary

HealthMetrics, based in Jakarta Selatan, is seeking a claims analyst to analyze corporate insurance claims, ensuring accuracy, completeness, and policy compliance.

The role involves reviewing supporting documents, applying analytical methods to spot discrepancies or fraud, and recommending resolutions based on policy terms. You will work with clients on inquiries and ensure timely adjudication.

Responsibilities

• Analyze insurance / Corporates claims to ensure accuracy, completeness, and adherence to policy terms and conditions
• Verify all supporting documentation submitted with claims, ensuring it meets the required standards and policies
• Utilize analytical tools and methodologies to detect potentially fraudulent activities or discrepancies in claim submissions
• Provide recommendations for claim resolution based on thorough analysis, supporting documentation, and policy terms
• Ensure strict adherence to company policies, procedures, and regulatory guidelines in all claim analysis activities
• Assist Clients in regard to inquiries and complaints coming
• Record the claim received (received data, adjudication timeframe, claim submission to clients

Job description

• Analyze insurance / Corporates claims to ensure accuracy, completeness, and adherence to policy terms and conditions
• Verify all supporting documentation submitted with claims, ensuring it meets the required standards and policies
• Utilize analytical tools and methodologies to detect potentially fraudulent activities or discrepancies in claim submissions
• Provide recommendations for claim resolution based on thorough analysis, supporting documentation, and policy terms
• Ensure strict adherence to company policies, procedures, and regulatory guidelines in all claim analysis activities
• Assist Clients in regard to inquiries and complaints coming
• Record the claim received (received data, adjudication timeframe, claim submission to clients