Dokter (Senior Claim Analyst)

Responsibilities:

• Analyze and assess health insurance claims in accordance with applicable medical guidelines, provisions, and authorization limits
• Review claim decisions and provide medical input or recommendations for complex cases, consultations, and special conditions
• Act as a Medical Advisor in the health insurance claim handling process
• Approve claim payment requests within the assigned authority and applicable per-claim limits
• Guide and supervise the claims team in handling medical cases and ensuring smooth claim processing and follow-up
• Coordinate with relevant departments, clients, healthcare providers, and other parties to support effective claim resolution
• Ensure claim decisions and processes are handled accurately, consistently, and in line with applicable policies and medical considerations

Requirements:

• Minimum education: Bachelor’s degree in Medicine (S.Ked.), with an interest in healthcare administration and health insurance
• Good knowledge of medical analysis, diagnosis, and clinical assessment
• Strong analytical, problem-solving, and decision-making skills, with attention to detail
• Strong communication and interpersonal skills, with the ability to collaborate effectively across teams
• Proficient in English, both written and spoken