Insurance Claims Analyst — Fluent English

PT. PRIMA SARANA JASA; Jakarta Utara; On-site; IDR 133,920,000 - 223,200,000; Full time

Benefits offered by this job

Medical benefits

Dental insurance

Performance bonus

BPJS Kesehatan

Retirement

Job summary

Global Excel Indonesia (PT Prima Sarana Jasa) is seeking a diligent Claim Assessor to evaluate insurance claims in accordance with policy coverage and internal guidelines. The role emphasizes strong English communication to liaise with policyholders, providers, and teams, ensuring accurate, timely decision-making.

You will review documents, medical reports, and invoices, identify fraudulent activity, maintain records, and collaborate with cross-functional teams to improve claims processes, while

Qualifications

• 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.

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

Analytical thinking

English proficiency

Communication skills

Attention to detail

Education

Bachelor's degree in related field

Job description

Global Excel Indonesia (PT Prima Sarana Jasa) is seeking a diligent Claim Assessor to evaluate insurance claims in accordance with policy coverage and internal guidelines. The role emphasizes strong English communication to liaise with policyholders, providers, and teams, ensuring accurate, timely decision-making.

You will review documents, medical reports, and invoices, identify fraudulent activity, maintain records, and collaborate with cross-functional teams to improve claims processes, while