Claim Assessor (Insurance & English Proficiency)

PT. PRIMA SARANA JASA; Daerah Khusus Ibukota Jakarta; On-site; USD 10,000 - 15,000; Full time

Job summary

A leading third-party administrator in Indonesia seeks a Claim Assessor to evaluate and process insurance claims. The role requires strong analytical skills and English proficiency to communicate effectively with various stakeholders. Join a team dedicated to simplifying healthcare access and exceeding customer expectations.

Qualifications

• Experience as a Claims Assessor required.

Responsibilities

• Review and analyze insurance claims based on policy coverage.
• Communicate with policyholders and healthcare providers.
• Ensure timely and accurate claim processing.

Skills

Analytical Skills

Attention to Detail

English Communication

Job description

Claim Assessor (Insurance & English Proficiency)

As a Claim Assessor at Global Excel Indonesia, you will be responsible for evaluating and processing insurance claims by analyzing policy coverage, reviewing supporting documents, and ensuring compliance with company guidelines. This role requires strong analytical skills, attention to detail, and proficiency in English to effectively communicate with policyholders, healthcare providers, and internal teams while ensuring accurate and timely claim assessments.

Key Responsibilities:

• Review and analyze insurance claims based on policy coverage and company guidelines.
• Assess supporting documents, medical reports, and invoices to determine claim validity.
• Communicate with policyholders, healthcare providers, and internal teams to clarify claim details.
• Ensure timely and accurate claim processing while maintaining compliance with regulations.
• Identify and report fraudulent or suspicious claims.
• Provide clear and professional explanations to clients regarding claim decisions.
• Maintain accurate records and documentation of claim assessments.
• Collaborate with cross-functional teams to enhance claim assessment processes.

This role demands strong English communication skills, both written and verbal, to handle international cases effectively.

Minimum Requirements:

• Experience as a Claims Assessor (number of years required).

Global Excel Indonesia (PT Prima Sarana Jasa) is a third-party administrator (TPA) with over two decades of experience in the Indonesian healthcare market.

Global Excel provides payers with a consultative approach to cost-effective, quality care programs through a single partnership. We deliver seamlessly tailored solutions 24/7 through our customer service and medical professionals by providing access to our network of certified healthcare facilities, ensuring highly effective cost containment.

At Global Excel, we aim to transform and simplify access to quality healthcare and strive to exceed customer expectations in everything we do.