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Lowongan Kerja AM – Claim Medical Officer Jakarta

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Jabatan: AM – Claim Medical Officer

Perusahaan: Prudential

Deskripsi Pekerjaan: At Prudential, we understand that success comes from the talent and commitment of our people. Together, we have a shared vision in securing the future of our customers and our communities. We strive to build a business that you can shape, an inclusive workplace where everyone’s ideas are valued and a culture where we can thrive together. Our people stay connected and tuned in to what’s happening around us, keeping us ahead of the curve. While focused on the long-term, we look to the future to bring growth, development and benefit to everyone whose lives we touch.

Claim Analyst, who are responsible to :

  • Analyze Hospitalization and non hospitalization claim based on policy provision and medical necessity, including investigation to hospital and/or treating doctors, if needed
  • Maintain and improvement service standard
  • Handling complaint and error monitoring
  • Improvement of product and system knowledge
  • Meet/call customer who need explanation on claim decision, coordinate with legal team for legal cases.

Medical Officer (CMO) :

  • 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
  • Design medical training structure for claim analyst

Being a team leader who holds RESPECT :

  • Lead team members with RESPECT
  • Coach and ensure team member attends/passes trainings/exams required
  • Monitor team by having productivity, errors and turn around time report
  • Create honest, supportive, open and competitive environment in team by having sufficient communications with team members
  • Ensure punctuality of team members are met
  • Ensure procedure in leave days is proper

Personal development :

  • ALMI designation (LOMA) within 2 years
  • Attend training designed for Medical Officer Excellence Program

Being center of excellence:

  • Analyze current process and give suggestion for process improvement
  • Involve in project to improve current process
  • Centre of knowledge (give training)

Ensure smooth communication with other departments

  • Doing meeting with other departments as needed to solve Claims issues
  • In difficult cases where problems are unsolved by team, ensure quick and justifiable solution is given
  • Ensure customer orientation is the basis for every approach

Liaise with Legal & Compliance to report suspicious transactions that finding in doing daily process

Ad-hoc assignment

Perkiraan Gaji:

Lokasi: Jakarta

Tanggal Lowongan: Thu, 03 Mar 2022 02:28:57 GMT

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