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Join us to work with a global team of leading talents in software engineering, big data and insurance as we embark on a mission to reinvent the insurance technology space and start seeing your work transform markets across Asia and the world
Assessor Lead
Everyday you will...
- Review, analyze and approve medical claims within authority limits.
- Supervise the junior claim assessor as well as engage with the squad/stakeholder to ensure a smooth claim process.
- Ensure compliance by following laws and regulations, internal control requirements, and the Sunday Care Claims policy.
- Act as a go-to-person for all complex claims and queries that may arise.
- Manage resources, capacity planning, and projections. Ensure that the team is working according to the committed SLAs.
- Automate anywhere possible. Come up with new initiatives and work with the tech team to implement the effective operations flow.
- Corresponds with internal departments, agents, medical providers, and others as required to gather necessary information to solve complex cases and summarize findings and recommend actions.
- They provide corporate clients with health risk consulting and advisory services that will positively impact employee health and well-being to support their talent management and financial goals.
- Improve and expand our dataset together with our data analytics and visualization team by ensuring that the data points provided by insurers exactly match our requirements to come up with our health data analysis.
- Collaborate and provide input to our data analytics and tech team on suitable reports that should be presented to our clients within the claims analytics dashboard module on our differentiated HR platform, to promote proactive risk management practices with our sales team and clients.
- Provide the needed clinician and health claims assessment skills in helping account managers to highlight relevant health issues and drive targeted risk management solutions.
- A bachelor's degree in medicine, healthcare management, or administration.
- Tech savvy, data-driven with experience as a Health Claims Assessor.
- At least 5 years experience in medical practice
- Be able to work independently.
- Experience of working in an insurer/broker company will be an advantage.
- Good in English speaking and writing.
- Excellent interpersonal and communication skills and the ability to effectively collaborate with diverse people within and across organizations.
Website
www.easysunday.co.id
Sunday