Health Insurance Claim Head

Cermati.com; Daerah Khusus Ibukota Jakarta; On-site; IDR 300.000.000 - 400.000.000; Full time

Job summary

A leading financial technology startup in Indonesia is seeking a Claim Manager for their Employee Benefit Insurance After Sale team. The ideal candidate will have over 5 years of experience in insurance or brokerage firms, excellent negotiation and communication skills, and the ability to maintain high client satisfaction levels. Responsibilities include processing claims, negotiating with insurance companies, and ensuring timely client service. Join us to be part of a dynamic fintech environment focused on innovation and client satisfaction.

Qualifications

• Over 5 years experience as Claim Manager in insurance or brokerage firms.
• Good relationships with insurance companies.
• Strong understanding of insurance terms and claim appeal process.

Responsibilities

• Lead the Employee Benefit Insurance After Sale team.
• Process claims and assist clients with endorsements.
• Negotiate and appeal rejected claims with insurance.
• Ensure quality and service excellence to clients.

Skills

Communication skills

Negotiation skills

Persuasion skills

Client relationship management

Adherence to SLA

Understanding of insurance terms

Job description

Company Description

Cermati is a financial technology (fintech) startup based in Indonesia. Cermati simplifies the process of finding and applying for financial product by bringing everything online so people can shop around for financial products online and can apply online without having to physically visit a bank.

Our team hailed from Silicon Valley Tech companies such as Google, Microsoft, LinkedIn and Sofi as well as Indonesian startups such as Doku, Touchten. We have graduates from well known universities such as Universitas Indonesia, ITB, Stanford, University of Washington, Cornell and many others. We are building a company with the same culture of openness, transparency, drive and meritocracy as Silicon Valley companies. Join us in our cause to build a world class fintech company in Indonesia.

Job Description

• Lead the Employee Benefit Insurance After Sale team including Data and Claim team
• Responsibilities of After Sale team include processing claims, assist clients with endorsements, documents and data keeping
• Oversees insurance claims that are in progress to make sure claim decision come out according to SLA and claim appraisal result is justified according to the agreed TC
• Assist clients who are admitted to hospital by coordinating with insurance and hospitals when necessary
• Make daily, weekly, and monthly report for claim updates
• Customer care helpline – 24 hours
• Develop and maintain relationships with insurance companies’ claim departments
• Negotiate and appeal rejected claims with insurance
• Monitor endorsement process and make sure SLA is achieved
• Check and make sure member cards are correct and send them to the clients on time
• Assist with client closing process by coordinating with insurance and making sure the policy T and C is as per agreed
• Put in place control mechanisms that enable achievement of high levels of customer satisfaction.
• Ensure quality and service excellence to clients and 5/5 client satisfaction
• Continuously improve current systems and processes
• Promote a culture of high performance and continuous improvement that values learning and commitment to quality.

Qualifications

• More than 5 years experience as Claim Manager in insurance or brokerage firms
• Have good relationships with insurance companies
• Excellent in communication, negotiation, and persuasion skills
• Strong adherence to SLA and maintaining clients expectations
• Able to respond to clients inquiry with lightning speed and accuracy
• Strong understanding of insurance terms and conditions and claim appeal process
• Background in medicine is preferred but not a must