Medical Advisor (Claims Review) - Hanwha Life Insurance Indonesia

Join Hanwha Life Insurance Indonesia as a Medical Advisor (Claims Review) and play a pivotal role in ensuring fair and accurate adjudication of medical insurance claims. In this critical position, you will leverage your clinical expertise to assess complex medical claims, ensuring that every case is evaluated with precision and integrity. Located in the heart of Jakarta Selatan, this role offers a dynamic environment where your contributions will directly impact the lives of policyholders. As a Medical Advisor, you will have the opportunity to grow professionally and make a meaningful difference in the insurance industry.

At Hanwha Life Insurance Indonesia, we are committed to providing exceptional service and innovative solutions to our clients. Our company has a rich history and a strong reputation for excellence in the insurance sector. In this role, you will work closely with our team of experts, utilizing advanced tools and technologies to streamline the claims review process. Your daily tasks will involve reviewing medical records, consulting with healthcare providers, and making informed decisions that align with our company's standards and regulations.

📋 Tanggung Jawab Pekerjaan

• Review and assess medical insurance claims with a focus on accuracy and compliance.
• Consult with healthcare providers to gather necessary information for claim evaluation.
• Utilize advanced software such as ClaimScape and Medisys to streamline the claims review process.
• Ensure adherence to company policies and regulatory requirements.
• Provide expert medical opinions on complex cases to support adjudication decisions.
• Collaborate with the claims team to resolve disputes and ensure timely processing of claims.
• Participate in continuous training and professional development to stay updated on industry best practices.
• Contribute to the improvement of internal processes and procedures for claims review.

🎓 Kualifikasi & Syarat

• Bachelor's degree in Medicine, Nursing, or a related healthcare field.
• Minimum of 5 years of experience in medical claims review or a related field.
• Certification in medical coding or billing is a plus.
• Strong knowledge of Indonesian healthcare regulations and insurance policies.
• Excellent communication and interpersonal skills.
• Proficiency in English and Indonesian languages.
• Familiarity with ClaimScape and Medisys software.
• Ability to work under pressure and meet tight deadlines.

🛠️ Keahlian

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