Case Management Staff

Job Description:

• Answer calls and handle any queries from the health care provider, insurance/payer, and patient.
• Manage and resolve complaints and escalate to supervisor/manager if needed.
• Responsible for daily Case Management and daily inpatient monitoring for a medical condition and expenses and identified cases to be escalated to supervisor/manager/ Medical Advisor.
• Guarantee issuance and online claim assessment.
• Complete all daily call log and daily inpatient monitoring log.
• Monitoring online transactions (claim) which haven’t send to Halodoc by a healthcare provider and do the follow-up on a weekly basis.
• Managed time for work on shifts, guided by the manager on 24/7 service deliverable.
• Accountable on daily operations to meet productivity or service standards as defined by management in line with department and/or division.

Requirements:

• Minimum qualification diploma (Nursing or other medical-related fields).
• 2 years working experience in healthcare, insurance, TPA, or related fields.
• Excellent knowledge of health insurance policy, health claims procedures, and terminology.
• Excellent knowledge of medical terminologies especially for treatment and surgeries or insurance.
• Computer literate.
• Good communication skills.
• Willing to work on shifting hours and public holidays.