Claim Assessor

Responsibility

• Review and validate hospital billing documents to ensure accuracy and completeness.
• Assess the appropriateness and correctness of billed expenses in accordance with policy terms.
• Analyze policy coverage and insurance limits to determine claim eligibility and ensure compliance with coverage conditions.
• Liaise with hospitals and relevant stakeholders to facilitate efficient claim processing.
• Evaluate and approve claims in adherence to the established Service Level Agreement (SLA).
• Perform additional duties as assigned to support operational efficiency.

Qualification

• Bachelor's degree in any field; candidates with at least 3 year of experience as a Claim Assessor, UR Nurse or experience in the insurance industry or nursing knowledge will be given special consideration.
• Detail-oriented and responsible for assigned tasks.
• Proficient in computer skills, with a strong command of MS Office.
• Strong communication skills, ability to work under pressure, service-minded, and highly responsible.
• Professional demeanor, excellent interpersonal skills, integrity, diligence, perseverance, and a positive attitude.