Senior Executive - Claim Medical Officer

Responsibility:

• Analyze hospitalization and non hospitalization claim based on policy provision and medical necessity, including investigation to hospital and/or treating doctors, if needed
• Prepare claim letter for claim paid and decline (if any)
• Maintain and improvement service standard
• Handling complaint and error monitoring
• Improvement of product and system knowledge
• As medical consultant for Claim Team specifically Claim Helpdesk Team and Claim Analyst.
• Develop medical knowledge for Claim Analyst to be able to independently process claim
• Handling Claim complex case; including accompany legal team or customer care team to handle OJK/litigation case dan meet customer.

Requirements:

• Have a Medical Doctor degree with minimal 3.00 GPA
• Have sufficient communication and interpersonal skills both in Indonesian and English.
• Have a good personality and work attitude and be able to work together in a team.
• Action-oriented and customer oriented
• Computer literate: word, excel, visio and power point applications