Deskripsi pekerjaan Claim Assessor (Medical Health Backround & English Proficiency) Global Excel Indonesia
Job Summary:
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.
Key Responsibilities:
- Review and analyze insurance claims based on policy coverage and company guidelines.
- Assess supporting documents, medical reports, and invoices to determine claim validity.
- Communicate with policyholders, healthcare providers, and internal teams to clarify claim details.
- Ensure timely and accurate claim processing while maintaining compliance with regulations.
- Identify and report fraudulent or suspicious claims.
- Provide clear and professional explanations to clients regarding claim decisions.
- Maintain accurate records and documentation of claim assessments.
- Collaborate with cross-functional teams to enhance claim assessment processes.
This role demands strong English communication skills, both written and verbal, to handle international cases effectively.
