job description
Join Compumed Services as a Claims Executive / Assistant in beautiful Bali and play a pivotal role in ensuring seamless healthcare claim processing for our clients. This position offers a unique opportunity to work in the dynamic field of medical insurance, where your attention to detail and organizational skills will directly impact customer satisfaction and operational efficiency.
As part of our growing team, you will adjudicate a variety of claimsâincluding admissions, outpatient services, and major medical claimsâwhile compiling and verifying supporting documentation to ensure accuracy and compliance with company policies and regulatory standards. This role is ideal for detail-oriented professionals who thrive in a structured yet fast-paced environment and are passionate about delivering exceptional service in the healthcare sector.
Baliâs vibrant work culture and Compumed Servicesâ commitment to professional development make this an exciting career opportunity for those looking to advance in the insurance and administrative support industry.
Responsibility
- Adjudicate and process healthcare claims, including admissions, outpatient, and major medical claims, in accordance with company guidelines and regulatory requirements.
- Review and compile supporting documents (e.g., medical reports, invoices, insurance forms) to validate claim eligibility and accuracy.
- Liaise with hospitals, clinics, and policyholders to clarify discrepancies or request additional information for claim verification.
- Maintain meticulous records of all processed claims, ensuring data integrity and confidentiality.
- Identify and escalate irregularities or fraudulent claims to the management team for further investigation.
- Provide administrative support to the claims department, including filing, data entry, and report generation.
- Stay updated on changes in healthcare policies, insurance regulations, and company procedures to ensure compliance.
- Collaborate with cross-functional teams to streamline claim processing workflows and improve efficiency.
Qualifications
- Diploma or Bachelorâs degree in Business Administration, Finance, Healthcare Management, or a related field.
- Minimum 1-2 years of experience in claims processing, insurance, or a similar administrative role (fresh graduates with relevant internships are encouraged to apply).
- Strong understanding of healthcare insurance terminology, policies, and claim procedures.
- Excellent attention to detail and analytical skills to assess claim validity and documentation.
- Proficient in Microsoft Office (Excel, Word) and familiar with claims management software or databases.
- Exceptional communication and interpersonal skills to interact with internal teams, healthcare providers, and clients.
- Ability to work independently, prioritize tasks, and meet deadlines in a high-volume environment.
- Fluency in English (written and spoken); knowledge of Indonesian (Bahasa) is a plus.