Health Insurance Claims Processor - Staff Provider

Join PT Nata Praja Solusindo as a Health Insurance Claims Processor and play a pivotal role in ensuring smooth and efficient claims management for our clients. This position is ideal for detail-oriented professionals with a passion for healthcare administration and a commitment to delivering exceptional service. Based in Jakarta Raya, you'll work closely with our team to handle a variety of insurance claims, from initial processing to final approval, ensuring accuracy and compliance with industry standards.

At PT Nata Praja Solusindo, we pride ourselves on our innovative approach to healthcare solutions and our dedication to our clients. As a Health Insurance Claims Processor, you'll have the opportunity to contribute to our mission of providing comprehensive and efficient healthcare services. Your daily tasks will include reviewing and processing insurance claims, verifying documentation, and resolving any discrepancies to ensure timely and accurate payments.

📋 Tanggung Jawab Pekerjaan

• Process and manage health insurance claims from initial submission to final approval, ensuring accuracy and compliance with industry regulations.
• Review and verify patient information, treatment details, and supporting documentation to ensure claims are legitimate and complete.
• Collaborate with healthcare providers and insurers to resolve any discrepancies or denied claims.
• Utilize insurance claims processing software such as ClaimWorks or Optum to streamline the claims management process.
• Maintain accurate and up-to-date records of all claims processed, including status updates and resolution notes.
• Stay informed about changes in insurance policies, regulations, and industry best practices to ensure ongoing compliance.
• Provide exceptional customer service to healthcare providers, patients, and insurers, addressing any inquiries or concerns in a timely and professional manner.
• Participate in team meetings and training sessions to share knowledge and best practices, contributing to the continuous improvement of our claims processing procedures.

🎓 Kualifikasi & Syarat

• Bachelor's degree in a related field, such as Healthcare Administration, Business Administration, or a similar discipline.
• Minimum of 2 years of experience in health insurance claims processing or a related field.
• Strong knowledge of insurance claims processing procedures, including the use of relevant software such as ClaimWorks or Optum.
• Excellent attention to detail and the ability to work accurately and efficiently under pressure.
• Strong communication and interpersonal skills, with the ability to build rapport with healthcare providers, patients, and insurers.
• Proficiency in English, both written and spoken, is a plus.
• Certification in health insurance claims processing or a related field is a plus.
• Ability to work independently and as part of a team, with a proactive and solution-oriented approach.

🛠️ Keahlian

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