Senior Executive – Medical Officer

Date Posted: Posted30+ hari yang lalu
Salary:
Jakarta

Job Description

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.

This job holder will responsible for delivering prompt and accurate results in the areas of claim process, managing overall team.

Principle Duties and Responsibilities:

1. Claim Analyst

  • Analyze Hospitalization claim based on policy provision and
  • Medical necessity, including investigation to hospital and/or
  • Treating doctors, if needed
  • Prepare claim letter for claim paid and decline
  • Maintain and improvement service standard
  • Handling complain and error monitoring
  • Improvement of product and system knowledge

2. 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

3. Personal development :

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

4. 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)

5. 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

6. Liaise with Legal & Compliance to report suspicious transactions that finding in doing daily process & Ad-hoc assignment

Job Requirements :

Qualification

  • Bachelor degree (Medical Doctor)
  • Fresh graduate or maximum 2 years in hospital
  • Strong analytical and inter-personal skill
  • Good problem solving skill
  • Having good sense of risk selection
  • Good communication skill
  • Pleasant personality, good attitude and good team working
  • Action-oriented and customer oriented
  • Good command in English
  • Computer literate : word, excel, visio and power point applications
  • Claim process, policy provision

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Job Detail

  • Job Id
    d4dea07ea9972b38
  • Location
    Jakarta
  • Company
  • Type
    Private
  • Employment Status
    Permanent
  • Positions
    Available
  • Career Level
    Experience
  • Gender
    Male/Female

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