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.