Claim Analyst

Job Description

• Received claim documents (cashless and reimbursement) into the system.
• Performed medical insurance claims assessment and adjudication according to the health insurance policy terms and conditions.
• Investigate claims through liaison parties to determine the eligibility of the claims
• Complete all daily call logs and daily claim log
• Prepare reports on a regular basis
• Accountable for daily operations to meet productivity or service standards defined by management in line with department and division.

Requirements:

• Minimum qualification diploma (Nursing or other medical-related fields)
• 2 years of 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.
• Computer literate
• Good communication skill
• Willing to work 5 working days Monday-Friday, weekends, or public holidays with working hours from 9 am - 6 pm.