Insurance Claim Officer - Digital Insurance

Company Description

Cermati is a financial technology (fintech) startup based in Indonesia. Cermati simplifies the process of finding and applying for financial products by bringing everything online so people can shop around for financial products online and can apply online without having to physically visit a bank.

Our team hails from Silicon Valley tech companies such as Google, Microsoft, LinkedIn, and Sofi, as well as Indonesian startups such as Doku and Touchten. We have graduates from well-known universities such as Universitas Indonesia, ITB, Stanford, University of Washington, Cornell, and many others. We are building a company with the same culture of openness, transparency, drive, and meritocracy as Silicon Valley companies. Join us in our cause to build a world-class fintech company in Indonesia.

Job Description

• Handle insurance recoupment and reconciliation works, communicate with providers and members via call and email for collection and explanation.
• Follow up on manual claims and SOP strictly, adjudicate claims according to benefit policies, and meet both financial / procedure accuracy and target on claims adjudication.
• Perform insurance claims assessment according to the actual situation.
• Review the approved claims to ensure accuracy and make adjustments as necessary.
• Generate daily claim processes and all related documents from the system and prepare claims documents to be sent to the payer.
• Investigate claims through liaison parties to determine the eligibility of the claims.
• Complete all daily call logs and daily claim logs.
• Prepare claim reports on a regular basis.
• Accountable for daily operations to meet productivity or service standards as defined by management in line with department and / or division.

Qualifications

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