Medical Claims & Benefits Analyst

Rumah Sakit Pondok Indah Group; Jakarta Selatan; On-site; IDR 167,400,000 - 279,000,000; Full time

Job summary

Rumah Sakit Pondok Indah Group is seeking a Claims Analyst/Medical Advisor to review employees’ medical treatments for health benefits eligibility at RS Pondok Indah, South Jakarta. This role requires careful evaluation of diagnoses, procedures, and treatment plans to ensure accurate claims decisions.

The successful candidate will collaborate with HR and internal teams, monitor benefits utilization, and prepare regular reports on claims. Medical MD degree and license are preferred.

Qualifications

• MD with active license (STR preferred) and at least 1 year in claims roles.
• Strong understanding of healthcare claims processes and employee health benefits.
• Ability to analyze medical diagnoses, procedures, and treatment plans.
• Excellent communication and cross-team coordination skills.
• Based at RS Pondok Indah – Pondok Indah, South Jakarta.

Responsibilities

• Review employees’ medical treatments and procedures to determine eligibility for coverage under the company’s health benefits.
• Monitor and evaluate the utilization of employee health benefits and coverage limits.
• Collaborate with Human Resource and relevant internal teams on employee health benefits.
• Prepare regular reports and analysis related to claims and employee health benefits.

Skills

Data analysis

Healthcare claims

Decision making

Communication

Coordination

Detail oriented

Report generation

Time management

Education

MD degree

Active medical license (STR) preferred

Job description

Rumah Sakit Pondok Indah Group is seeking a Claims Analyst/Medical Advisor to review employees’ medical treatments for health benefits eligibility at RS Pondok Indah, South Jakarta. This role requires careful evaluation of diagnoses, procedures, and treatment plans to ensure accurate claims decisions.

The successful candidate will collaborate with HR and internal teams, monitor benefits utilization, and prepare regular reports on claims. Medical MD degree and license are preferred.