Claim Analyst

Rey.id; Jakarta Pusat; On-site; IDR 66,960,000 - 100,440,000; Full time

Job summary

Rey.id is seeking a claim analyst to review and verify health insurance claim documents and validate AI-driven analyses. You will identify discrepancies, ensure SOP/SLA adherence, and prepare comprehensive claim reports while maintaining strict data confidentiality.

The role requires 2+ years in health insurance and strong attention to detail. Ideal candidates adapt quickly to AI-assisted systems, communicate clearly with internal teams, and work independently as well as collaboratively within a

Qualifications

• Minimum Diploma/Bachelor's degree in Nursing, Midwifery, Public Health, or related medical background.
• Minimum 2 years of experience in a Health Insurance company.
• Strong analytical thinking and problem-solving skills.
• Detail-oriented with high accuracy in handling data and documents.
• Familiar with claim verification and healthcare documentation.
• Adaptable, quick learner, and comfortable working with technology/AI-assisted systems.
• Proactive, initiative-driven, and able to work independently as well as collaboratively.
• Good communication skills in handling internal coordination and member inquiries.

Responsibilities

• Review and verify claim documents for completeness and accuracy.
• Validate AI-generated claim analysis results with supporting documents.
• Identify discrepancies, incomplete documents, or potential fraud cases.
• Ensure claim processing complies with SOP and SLA.
• Prepare and maintain claim reports and documentation.
• Provide accurate claim-related information and support member inquiries.
• Maintain confidentiality of member data and personal information.

Skills

Analytical thinking

Problem-solving

Attention to detail

Communication skills

Adaptability

Fast learner

Independence

Education

Diploma/Bachelor in Nursing/Health fields

Tools

AI-assisted systems

Job description

Rey.id is a technology-driven health and life insurance provider in Indonesia, offering a holistic approach to healthcare services and well-being. Unlike traditional insurance products, Rey focuses on quality healthcare services to improve the lives of its members. The company is committed to reimagining and democratizing life and health insurance to make it more desirable and beneficial.

Job Description:

• Review and verify claim documents to ensure completeness and accuracy such as verify and ensure completeness of claim documents, classify claim documents based on claim type and services, and identify incomplete or invalid documents and identify incomplete or invalid documents and ?
• Validate AI-generated claim analysis results with supporting documents, from review and validate AI-generated claim analysis results, ensure accuracy of claim data such as diagnosis, cost, and service date
• Identify discrepancies, incomplete documents, or potential fraud cases
• Ensure claim processing complies with SOP and SLA
• Prepare and maintain claim reports and documentation
• Provide accurate claim-related information and support member inquiries
• Maintain confidentiality of member data and personal information

Requirement:

• Minimum Diploma/Bachelor's degree in Nursing, Midwifery, Public Health, or related medical background
• Minimum 2 years of experience in a Health Insurance company
• Strong analytical thinking and problem-solving skills
• Detail-oriented with high accuracy in handling data and documents
• Familiar with claim verification and healthcare documentation
• Adaptable, quick learner, and comfortable working with technology/AI-assisted systems
• Proactive, initiative-driven, and able to work independently as well as collaboratively
• Good communication skills in handling internal coordination and member inquiries