Clinical Claims Analyst - Medical Helpdesk

Manulife; Jakarta Pusat; On-site; IDR 120,000,000 - 160,000,000; Full time

Benefits offered by this job

Flexible environment

Career growth

Inclusive workplace

Job summary

Manulife Indonesia is seeking a Medical Helpdesk Support to review and assess medical claims from a clinical perspective, ensuring treatments and hospitalizations comply with medical guidelines and company policies.

The role supports pre-approval requests, reviews medical records and supporting documents, and collaborates with hospitals and internal teams to clarify claim information for informed decisions.

Qualifications

• Bachelor’s degree in healthcare, medical sciences, nursing or related field.
• Fresh graduates or doctors with 1–2 years of clinical experience welcome to apply.
• Experience as GP, internship doctor, or hospital/clinic setting is an advantage.
• Strong ability to review and interpret medical records and clinical documentation.
• Proficient in Microsoft Office applications.

Responsibilities

• Review and assess medical claims (reimbursement, and cashless) from a clinical perspective.
• Validate diagnosis, treatment, and hospitalization against guidelines.
• Support pre-authorization for hospital and non-hospital cases.
• Assess medical necessity, length of stay, and treatment plans.
• Analyze medical records, discharge summaries and supporting documents.
• Ensure completeness and accuracy of claim documentation.
• Assist in reviewing medical disputes and appeal cases.
• Provide clinical input to support claim decisions.
• Follow up on incomplete or unclear documentation.
• Identify overutilization or inconsistencies in claims.

Skills

Clinical judgment

Attention to detail

Documentation skills

Communication skills

Stakeholder coordination

Education

Bachelor's Degree in Healthcare/Medical Sciences/Nursing

Tools

Microsoft Office

Job description

Manulife Indonesia is seeking a Medical Helpdesk Support to review and assess medical claims from a clinical perspective, ensuring treatments and hospitalizations comply with medical guidelines and company policies.

The role supports pre-approval requests, reviews medical records and supporting documents, and collaborates with hospitals and internal teams to clarify claim information for informed decisions.