Insurance Claim Analyst — English Pro, Medical Perks

PT. PRIMA SARANA JASA; Jakarta Selatan; On-site; IDR 78,120,000 - 133,920,000; Full time

Benefits offered by this job

Medical allowance

Miscellaneous allowance

Dental

Bonus performance

BPJS Kesehatan

Pensiun

Job summary

Global Excel Indonesia (PT Prima Sarana Jasa) is seeking a dedicated Claim Assessor to evaluate insurance claims by analyzing policy coverage and supporting documents. Strong English communication, attention to detail, and analytical thinking are essential to interact with policyholders, healthcare providers, and internal teams while ensuring timely, accurate claim decisions.

The role emphasizes compliance with regulations, fraud detection, and clear explanations to clients.

Qualifications

• Proficiency in English to communicate with policyholders and providers.
• Experience in insurance claim assessment.
• Ability to analyze policy coverage and supporting documents.

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.

Skills

Strong English communication skills

Analytical skills

Attention to detail

Job description

Global Excel Indonesia (PT Prima Sarana Jasa) is seeking a dedicated Claim Assessor to evaluate insurance claims by analyzing policy coverage and supporting documents. Strong English communication, attention to detail, and analytical thinking are essential to interact with policyholders, healthcare providers, and internal teams while ensuring timely, accurate claim decisions.

The role emphasizes compliance with regulations, fraud detection, and clear explanations to clients.