Senior Medical Claims Lead

MEDITAP; Tangerang; On-site; IDR 167,400,000 - 279,000,000; Full time

Job summary

Meditap, an Indonesia-based health administration partner, is seeking a Medical Doctor (General Practitioner) with a valid STR license. The role blends clinical insight with claims analysis, supervising staff, and coordinating across teams to ensure accurate adjudication of health and insurance claims.

The candidate should have at least 1 year of healthcare or insurance claims experience, strong medical knowledge, and proficiency in Excel/Sheets for reporting.

Qualifications

• Minimum 1 year of experience in healthcare, insurance, TPA, or hospital claim management.
• Strong knowledge of medical terminology, healthcare procedures, and claim adjudication processes.
• Familiar with healthcare regulations and insurance policies.
• Ability to analyze medical claims and provide medical recommendations.
• Proven leadership and team management experience.
• Strong communication and coordination across teams and stakeholders.
• Proficient in Microsoft Office/Google Workspace for reporting and analysis.
• Uphold data privacy and handle confidential information with integrity.

Responsibilities

• Conduct analysis and decision-making on claim submissions per guidelines and authority levels.
• Review, approve, and ensure claim submissions and follow-up processes are carried out accurately and on time by the supervised team, while maintain coordination with all relevant stakeholders.
• Provide medical input, recommendations, or solutions for consultations and special medical cases related to claims, within the applicable authority.
• Review and verify coordination of COB letters prepared by claim input staff.
• Implement departmental work programs in coordination with superiors and the supervised team.
• Coordinate and supervise the team within the scope of authority in interactions with related departments and clients/customers to ensure effective service delivery.

Skills

Medical terminology

Claim analysis

Leadership

Communication

Confidential data handling

Reporting and analysis

Tools

Microsoft Office

Excel

Google Sheets

Job description

Meditap, an Indonesia-based health administration partner, is seeking a Medical Doctor (General Practitioner) with a valid STR license. The role blends clinical insight with claims analysis, supervising staff, and coordinating across teams to ensure accurate adjudication of health and insurance claims.

The candidate should have at least 1 year of healthcare or insurance claims experience, strong medical knowledge, and proficiency in Excel/Sheets for reporting.