Claim Analyst

Key Responsibilities

• Receive and input cashless and reimbursement claim documents into the system.

• Perform medical insurance claims assessment and adjudication according to the health insurance policy terms and conditions.

• Investigate claims through liaison parties to determine the eligibility of the claims.

• Complete all daily call logs and daily claim logs.

• Prepare reports on a regular basis.

• Be accountable for daily operations to meet productivity or service standards defined by management in line with department and division.

Requirements

• Minimum qualification of a Diploma (D3) in Nursing or other medical-related fields.

• 2 years of working experience in healthcare, insurance, TPA, or related fields.

• Excellent knowledge of health insurance policy, health claims procedures, and terminology.

• Excellent knowledge of medical terminologies, especially for treatment and surgeries.

• Computer literate.

• Good communication skills.