Deskripsi pekerjaan PIC ANALIS KLAIM (NAKES) PT Nata Praja Solusindo
About the role
Support the claims manager in managing and monitoring all aspects of restitution claims activities in the region. Responsible for the entire restitution claims process in the region.
Key responsibilities
- Ensure the restitution claims process complies with the restitution claims flow
- Conduct analysis of claims documents and evidence based on applicable regulations
- Conduct investigations related to claims documents
- Ensure data is available for reconciliation with healthcare facilities and providers in the region when needed
- Ensure restitution claims reports are available to be submitted to the claims manager
- Control activity reports of regional PIC
- Create recapitulation reports of regional PIC
- Perform reconciliation of restitution claims and provider claims to healthcare facilities and providers in the region
- Create reports on approved, pending, and rejected restitution claims
About you
- Bachelor's degree (S1) or Diploma (D3) in healthcare field
- Preferred to have experience in insurance
