Asset Publisher

Asset Publisher

null Medical Services Manager
Karier

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Job Descriptions:

  • To ensure end to end process of cashless claim properly and in accordance with procedure & TAT
  • Initial LoG, review LoG and ensure completion document for complex/advance/high amount case, and approve initial LoG
  • Ensure initial LoG send to hospital within SLA (60 minutes)
  • Case monitoring (daily monitoring)
  • Monitor case monitoring process to ensure adhere with procedure and within timeline
  • Negotiate to hospital if needed (for special case or if hospital not cooperative)
  • Review LoG and ensure completion document for complex/ advance/ high amount case
  • Approve final LoG
  • Ensure initial LoG send to hospital within SLA (60 minutes)
  • Monitor weekly performance and propose the action plan if any challenges
  • To ensure end to end process of incoming call from Customer, Distribution and Hospital properly and in accordance with procedure & SLA
  • Handling customer enquiry or customer complaint
  • Monitor weekly performance and propose the action plan if any challenges
  • To ensure end to end process of incoming email from Customer and Distribution properly and in accordance with procedure & SLA
  • Handling customer enquiry or customer complaint
  • Ensure chronology or information related customer complaint send properly to CMU team
  • Monitor weekly performance and propose the action plan if any challenges/ issue
  • Review Claim Pre-Authorization and ensure completion document for complex/ advance/ high amount case
  • Approve & monitor Claim Pre-Authorization process to ensure adhere with procedure and within timeline (5 Working days)
  • Responsible for managing, coaching and developing direct reports, as well as ensuring other team members are receiving the support they require to achieve team and company goals and individual performance standards.
  • Manage team member and organization development, including performance management, retention and succession planning

Requirements:

  • Bachelor’s degree from Medical
  • Min. 5 years experiences in claim insurance industry
  • Medical training
  • Insurance knowledge training
  • Knowledge of medical expertise 
  • Knowledge of claim management
  • English communication skill
  • Certification of insurance (e.g. LOMA, Pamjaki, AMAI, etc.)
  • Communication, negotiation & presentation skill
  • People manager

Send your updated CV and signed AXA Mandiri Privacy Notice to work@axa-mandiri.co.id with subject: Name - Position

 

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