Cermati.com is hiring a

Health Insurance Claim Head

Jakarta, Indonesia
Full-Time
  • Lead the Employee Benefit Insurance After Sale team including Data and Claim team
  • Responsibilities of After Sale team include processing claims, assist clients with endorsements, documents and data keeping
  • Oversees insurance claims that are in progress to make sure claim decision come out according to SLA and claim appraisal result is justified according to the agreed TC
  • Assist clients who are admitted to hospital by coordinating with insurance and hospitals when necessary
  • Make daily, weekly, and monthly report for claim updates
  • Customer care helpline – 24 hours
  • Develop and maintain relationships with insurance companies’ claim departments
  • Negotiate and appeal rejected claims with insurance
  • Monitor endorsement process and make sure SLA is achieved
  • Check and make sure member cards are correct and send them to the clients on time
  • Assist with client closing process by coordinating with insurance and making sure the policy T and C is as per agreed
  • Put in place control mechanisms that enable achievement of high levels of customer satisfaction.
  • Ensure quality and service excellence to clients and 5/5 client satisfaction
  • Continuously improve current systems and processes
  • Promote a culture of high performance and continuous improvement that values learning and commitment to quality.
  • More than 5 years experience as Claim Manager in insurance or brokerage firms
  • Have good relationships with insurance companies
  • Excellent in communication, negotiation, and persuasion skills
  • Strong adherence to SLA and maintaining clients expectations
  • Able to respond to clients inquiry with lightning speed and accuracy
  • Strong understanding of insurance terms and conditions and claim appeal process
  • Background in medicine is preferred but not a must
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