Claims Assessor

As a Claims Assessor at Global Excel Indonesia, you will be responsible for evaluating and processing insurance claims by analyzing policy coverage, reviewing supporting documents, and ensuring compliance with company guidelines. This role requires strong analytical skills, attention to detail, and proficiency in English to effectively communicate with policyholders, healthcare providers, and internal teams while ensuring accurate and timely claim assessments.

Key Responsibilities:

• Review and analyze insurance claims based on policy coverage and company guidelines.
• Assess supporting documents, medical reports, and invoices to determine claim validity.
• Communicate with policyholders, healthcare providers, and internal teams to clarify claim details.
• Ensure timely and accurate claim processing while maintaining compliance with regulations.
• Identify and report fraudulent or suspicious claims.
• Provide clear and professional explanations to clients regarding claim decisions.
• Maintain accurate records and documentation of claim assessments.
• Collaborate with cross-functional teams to enhance claim assessment processes.

Requirements:

• Minimum Diploma or Bachelor's Degree in Public Health/Actuary/Underwriting, Nursing, or any related major.
• Strong English communication skills , both written and verbal, to handle international cases effectively.
• Analytical skills and attention to detail in assessing and processing claims.
• Excellent written and oral communication skills to handle correspondence.
• Good time management skills and ability to prioritize workloads to meet deadlines.
• Experience in Customer Service and Claim Analyst, in the Healthcare or Health Insurance Industry will be an advantage.