job description
Join PT Nata Praja Solusindo as a Healthcare Claims Specialist in the vibrant and culturally rich regions of Bali, including Canggu, Ubud, Denpasar, Jimbaran, Nusa Dua, Kuta, and Badung. This is a unique opportunity to contribute to the healthcare sector while enjoying the tropical paradise of Bali.
In this role, you will play a critical part in ensuring the accuracy and integrity of healthcare claims processing. Your meticulous attention to detail and analytical skills will help streamline operations, reduce discrepancies, and support the delivery of high-quality healthcare services. This position is ideal for professionals who thrive in a structured yet dynamic environment and are passionate about making a difference in the medical field.
As part of our team, you will collaborate with cross-functional departments to resolve claim-related issues, maintain compliance with regulatory standards, and enhance overall efficiency. Whether you are an experienced healthcare professional or looking to transition into this rewarding field, this role offers growth, stability, and the chance to work in one of Indonesia’s most sought-after locations.
Responsibility
- Investigate and verify healthcare claim documents to ensure accuracy and compliance with company policies and regulatory requirements.
- Perform detailed data analysis to identify discrepancies, errors, or missing information in claims submissions.
- Reconcile claim data with financial records and patient information to ensure consistency and resolve inconsistencies.
- Collaborate with healthcare providers, insurance companies, and internal teams to clarify claim details and expedite processing.
- Maintain up-to-date knowledge of healthcare regulations, coding standards (e.g., ICD-10), and industry best practices.
- Prepare and submit reports on claim processing metrics, including turnaround times, error rates, and resolution outcomes.
- Assist in the development and implementation of process improvements to enhance efficiency and reduce claim denials.
- Provide exceptional customer service by addressing inquiries from patients, providers, and stakeholders regarding claim status and issues.
Qualifications
- Bachelor’s degree in Health Administration, Nursing, Public Health, or a related field. Diploma holders with relevant experience may also apply.
- Minimum 2 years of experience in healthcare claims processing, medical billing, or a similar role.
- Strong understanding of medical terminology, coding (ICD-10, CPT), and insurance claim procedures.
- Proficient in using claims management software and Microsoft Office (Excel, Word).
- Excellent analytical, problem-solving, and organizational skills with a keen eye for detail.
- Ability to work independently and in a team, managing multiple priorities in a fast-paced environment.
- Fluent in English and Indonesian (written and verbal) to communicate effectively with diverse stakeholders.
- Familiarity with Indonesian healthcare regulations and BPJS systems is a plus.