job description
Are you a detail-oriented professional with a passion for healthcare and data accuracy? Health Maintenance Inc. is seeking a Medical Claims Analyst to join our dynamic team in Bali, Indonesia. This is your opportunity to elevate your career in a fast-paced, impactful role where your analytical skills will directly contribute to improving healthcare efficiency and patient outcomes.
As a Medical Claims Analyst, you will play a critical role in reviewing, processing, and resolving medical claims to ensure compliance with company policies and regulatory standards. Your expertise will help streamline operations, reduce errors, and enhance the overall claims management process. If you thrive in a collaborative environment and are eager to make a difference in the healthcare industry, we want to hear from you!
Join us in Canggu, Bali—a vibrant hub for professionals seeking work-life balance, cultural richness, and career growth. Submit your application today and take the next step toward a rewarding future with Health Maintenance Inc.
Responsibility
- Review and process medical claims for accuracy, completeness, and compliance with company policies and regulatory requirements.
- Identify and resolve discrepancies, errors, or missing information in claims submissions.
- Collaborate with healthcare providers, insurance companies, and internal teams to clarify claim details and facilitate timely resolutions.
- Maintain detailed records of claims processing activities, including approvals, denials, and appeals.
- Analyze claims data to identify trends, inefficiencies, or areas for process improvement.
- Prepare and submit reports on claims processing metrics, including turnaround times and error rates.
- Stay updated on changes in healthcare regulations, coding standards (e.g., ICD-10, CPT), and industry best practices.
- Provide exceptional customer service to internal and external stakeholders regarding claims-related inquiries.
Qualifications
- Bachelor’s degree in Healthcare Administration, Nursing, Finance, Business, or a related field. Relevant certifications (e.g., Certified Professional Coder) are a plus.
- Minimum of 2 years of experience in medical claims processing, healthcare billing, or a similar role.
- Strong knowledge of medical terminology, coding systems (ICD-10, CPT, HCPCS), and insurance claim procedures.
- Proficiency in claims management software (e.g., Epic, Cerner, or proprietary systems) and Microsoft Office Suite.
- Excellent analytical, problem-solving, and attention-to-detail skills.
- Ability to work independently and collaboratively in a fast-paced environment with tight deadlines.
- Strong communication and interpersonal skills to liaise with providers, insurers, and team members.
- Familiarity with healthcare compliance regulations (e.g., HIPAA, GDPR) is advantageous.