Info Lowongan Kerja

Global Excel Indonesia (PT Prima Sarana Jasa)

OPEN RECRUITMENT (CLAIM ASSESSOR)

Deskripsi Pekerjaan

As a Claim Assessor at Global Excel Indonesia, you will be responsible for evaluating and processing insurance claims by analyzing policy coverage, reviewing supporting documents, and ensuring compliance with company guidelines. This role requires strong analytical skills, attention to detail, and proficiency in English to effectively communicate with policyholders, healthcare providers, and internal teams while ensuring accurate and timely claim assessments.

Tugas dan Tanggung Jawab

a.) Review and analyze insurance claims based on policy coverage and company guidelines.

b.) Assess supporting documents, medical reports, and invoices to determine claim validity.

c.) Communicate with policyholders, healthcare providers, and internal teams to clarify claim details.

d.) Ensure timely and accurate claim processing while maintaining compliance with regulations.

e.) Identify and report fraudulent or suspicious claims.

f.) Provide clear and professional explanations to clients regarding claim decisions.

g.) Maintain accurate records and documentation of claim assessments.

h.) Collaborate with cross-functional teams to enhance claim assessment processes.

Persyaratan

a.) Bachelor’s degree in any field, preferably in Insurance, Healthcare, English, or Business Administration.

b.) Strong English communication skills, both written and verbal (minimum TOEFL score of 500 or IELTS 6.0 is a plus).

c.) Ability to analyze insurance claims, medical reports, and invoices with accuracy and attention to detail.

d.) Excellent analytical and problem-solving skills.

e.) Able to work independently and collaboratively with cross-functional teams.

f.) Prior experience in insurance or healthcare-related roles is an advantage.

g.) Comfortable working under deadlines and in a target-driven environment.

h.) Proficient in using computers and office applications (especially Microsoft Excel and Word).

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