Primary Responsibility
• Manage Claim Operation as well as employee selection, development and performance management• Monitor claim metrics to ensure the department are meeting financial and nonfinancial objective Decisive action would be taken when result are not meeting the department objective• Monitor current practices and procedures to ensure protocols are met and claim service are effective and efficient• Communicate with global office on cliam decision above local country• Involve in product development process by working cross functionally with UW, Actuary, Product Marketing, Distribution team regarding claim trends and other issue• Prepare and monitor annual operating budget• Claims assessment monitoring to ensure the claims procedure and workflow are in place according to the claims guidelines• Conduct Claims investigation• Record and report the claims data• Analyze claims trend data and anticipate the possible trend major changes
Qualification
Qualification
• Strong medical background• Minimum 5 years of Experience in claims (major claims experience is preferred)• Familiar with BMAI or other customer conflict intermediary process including litigation• Certified with relevant qualifications (A3IJ, CPLHI, FLMI, PAMJAKI)• Claims audit and/or claims investigation experience• Familiar with hospital/medical procedure in Indonesia and/or other market• Experience in product development,• Experience in claims system development/enhancement Education and Other Requirements:• Medical degree/background (pharmacist, medical, nursing, public health) or• Insurance related bachelor degree (actuary, etc)• Mathematician / statistician
Informasi lebih lanjut
Bidang Pekerjaan |
Status Kepegawaian |
Dokter, Medical Sales
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Full-Time
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Pendidikan Terakhir |
Gaji |
-
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Sesuai Peraturan Perusahaan
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Tingkat Jabatan |
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-
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-
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