Apprenticeship - Group Claim Services

Job Description

Responsibilities:

• Send information of members currently having Inpatient treatment to CR Team.
• Send information to CR about inpatient treatment that has exceeded high-cost threshold.
• Support arranging Health Talk event and Simple MCU with provider network
• Support event of PRUWorks socialization to provider network.
• Support claim team in preparing e-flyer of Health Talk by communicating with Marketing Team.
• Support Team Penjaminan in responding WAG.
• Support the team to arrange meetings with vendors.
• Support claim team in preparing Health Bulletin to be shared to clients.
• Receive incoming claim documents from the mailing room and maintain the claim logbook to ensure proper tracking and documentation of all received claims
• Register claim data into the system accurately and in a timely manner to support the claim processing workflow.
• Scan claim documents and ensure all relevant records are properly digitized and stored.
• Organize and separate claim documents according to the required processing categories and documentation standards.
• Upload claim transaction data into the system and verify data accuracy to support efficient claim administration.

Requirements:

• Bachelor's degree in Nursing/Public Health/Midwifery
• Willing to work fully on-site at Prudential Centre, Kota Kasablanka (Mon-Fri; 08.00-17.00 WIB).