Medical Claims Analyst for Employee Wellness

Blibli; Jakarta Pusat; On-site; IDR 133,920,000 - 200,880,000; Full time

Job summary

Blibli is seeking a Medical Claim Junior Officer to ensure employees receive appropriate healthcare benefits through accurate medical claim assessments. You will interpret diagnoses, evaluate treatments, and coordinate with healthcare providers to resolve issues, contributing to broader employee well-being initiatives.

The role requires a strong healthcare background and at least 3 years of relevant experience in medical claims or health insurance, with excellent attention to detail and

Qualifications

• Bachelor’s degree in Healthcare, Nursing, Pharmacy, Public Health, Medicine, or related field.
• Minimum 3 years of relevant experience in Medical Claims, Healthcare Administration, Health Insurance, or similar roles.
• Strong medical knowledge including diseases, diagnoses, and treatments.
• Ability to read and interpret doctors' prescriptions and notes.

Responsibilities

• Review and analyze employee medical claims (outpatient, inpatient, dental, optical).
• Evaluate claim eligibility based on medical information, insurance coverage, and policies.
• Coordinate with insurance companies, hospitals, and providers to manage claims.
• Monitor pending claims and follow up on discrepancies or suspicious claims.
• Prepare and monitor medical claim payment requests.
• Analyze healthcare utilization to recommend benefit improvements.

Skills

Strong medical knowledge

Communication skills

Analytical thinking

Attention to detail

Excel

Education

Bachelor's in Healthcare/Medicine/Nursing/Public Health

Tools

Microsoft Excel

Job description

Blibli is seeking a Medical Claim Junior Officer to ensure employees receive appropriate healthcare benefits through accurate medical claim assessments. You will interpret diagnoses, evaluate treatments, and coordinate with healthcare providers to resolve issues, contributing to broader employee well-being initiatives.

The role requires a strong healthcare background and at least 3 years of relevant experience in medical claims or health insurance, with excellent attention to detail and