job description
Join Compumed Services as a Claims Executive / Assistant in the vibrant heart of Bali! This is a unique opportunity to play a pivotal role in healthcare administration, ensuring seamless processing of medical claims while contributing to the efficiency of our insurance operations.
In this dynamic position, you will be responsible for adjudicating a variety of claims, including admission, outpatient, and major medical claims, while meticulously compiling and verifying supporting documentation. Your attention to detail and analytical skills will directly impact the accuracy and timeliness of claim settlements, enhancing client satisfaction and operational excellence.
Based in Badung, you’ll work in a collaborative environment that values precision, integrity, and customer-centric solutions. Whether you're an experienced claims professional or an aspiring assistant looking to grow in the healthcare insurance sector, this role offers a rewarding career path with opportunities for development.
If you thrive in a structured yet fast-paced setting and are passionate about delivering high-quality administrative support, we’d love to hear from you!
Responsibility
- Adjudicate and process inpatient, outpatient, and major medical claims in compliance with company policies and regulatory standards.
- Review and verify the completeness and accuracy of supporting documents, including medical reports, invoices, and insurance forms.
- Liaise with hospitals, clinics, and policyholders to clarify discrepancies or request additional information.
- Maintain meticulous records of all claims processed, ensuring traceability and audit readiness.
- Identify and escalate fraudulent or suspicious claims for further investigation.
- Prepare and submit daily, weekly, and monthly reports on claims processing metrics and trends.
- Collaborate with the finance team to ensure timely reimbursements and payments to service providers.
- Stay updated on healthcare regulations, insurance policies, and industry best practices to ensure compliance.
Qualifications
- Diploma or Bachelor’s degree in Business Administration, Finance, Healthcare Management, or a related field.
- Minimum 1-2 years of experience in claims processing, insurance, or healthcare administration (fresh graduates with relevant internships are encouraged to apply).
- Strong understanding of medical terminology, coding (ICD-10), and insurance procedures.
- Excellent attention to detail and ability to analyze complex documentation.
- Proficient in Microsoft Office (Excel, Word) and familiar with claims management software.
- Exceptional communication and interpersonal skills to interact with stakeholders professionally.
- Ability to work under tight deadlines while maintaining accuracy and efficiency.
- Fluency in English (written and verbal); knowledge of Bahasa Indonesia is a plus.