Dokter (Senior Claim Analyst)

PT Lippo General Insurance Tbk; Tangerang; On-site; IDR 150,000,000 - 320,000,000; Full time

Job summary

PT Lippo General Insurance Tbk is seeking a Medical Advisor to analyze and approve health insurance claims in line with medical guidelines and authorization limits.

The role involves reviewing complex cases, providing medical input, guiding the claims team, and coordinating with clients and providers to ensure accurate and compliant claim handling.

Qualifications

• Bachelor’s degree in Medicine (S.Ked.)
• Interest in healthcare administration and health insurance
• Good knowledge of medical analysis, diagnosis and clinical assessment
• Strong analytical, problem-solving, and decision-making skills, with attention to detail
• Strong communication and interpersonal skills with the ability to collaborate across teams
• Proficient in English, both written and spoken

Responsibilities

• Analyze and assess health insurance claims in accordance with medical guidelines, provisions, and authorization limits
• Review claim decisions and provide medical input or recommendations for complex cases
• Act as a Medical Advisor in the health insurance claim handling process
• Approve claim payment requests within assigned authority and per-claim limits
• Guide and supervise the claims team in handling medical cases and ensuring smooth claim processing and follow-up
• Coordinate with relevant departments, clients, healthcare providers, and other parties to support effective claim resolution
• Ensure claim decisions and processes are handled accurately, consistently, and in line with policies and medical considerations

Skills

Medical analysis

Clinical assessment

Analytical thinking

Problem solving

Decision making

Effective communication

Education

Bachelor’s degree in Medicine (S.Ked.)

Job description

Analyze and assess health insurance claims in accordance with applicable medical guidelines, provisions, and authorization limits

Review claim decisions and provide medical input or recommendations for complex cases, consultations, and special conditions

Act as a Medical Advisor in the health insurance claim handling process

Approve claim payment requests within the assigned authority and applicable per-claim limits

Guide and supervise the claims team in handling medical cases and ensuring smooth claim processing and follow-up

Coordinate with relevant departments, clients, healthcare providers, and other parties to support effective claim resolution

Ensure claim decisions and processes are handled accurately, consistently, and in line with applicable policies and medical considerations

Requirements:

Minimum education: Bachelor’s degree in Medicine (S.Ked.), with an interest in healthcare administration and health insurance

Good knowledge of medical analysis, diagnosis, and clinical assessment

Strong analytical, problem-solving, and decision-making skills, with attention to detail

Strong communication and interpersonal skills, with the ability to collaborate effectively across teams

Proficient in English, both written and spoken