Supervisor

Claim Reimbursement
  • Provide supports to team in handling the reimbursement claims.
  • Investigate and make decision for claims reimbursement in the system, by covering the below actions:
    o Approve for the payment base on authorization.
    o Perform rejection of claims reimbursement
    o Require the additional information
  • Issue memo into the system for administration in performing next steps
  • Submit for further investigation
  • Request the hospital records from hospital
  • Continuously monitor and make decision for the pending cases of Claims Reimbursement, or back log
  • Consolidate the complex cases which requires for Claim Committee Decision, and present to Claim Committee and COO/ CEO according to the authorization
  • Bachelor’s or Master’s Degree in Business Administration, Nursing, Business of Sciences (Medical Technology), or other related field
  • 1 - 3 years’ experience in Claims Assessor, or other related fields in insurance industry
  • Knowledge of claims management policies and processes
  • Professional nursing/ medical knowledge
  • Knowledge of insurance industry and product
  • Good Coordination & Communication skills

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