Claim Assessor (Health) - General Claims (Bangkok)
Description
Review and assess hospital bills, verify policy coverage, coordinate with hospitals, approve claims per SLA, and ensure accurate claim processing.
Responsibility
- Review and validate hospital billing documents and direct claim document to ensure accuracy and completeness.
- Assess the appropriateness and correctness of billed expenses in accordance with policy terms.
- Analyze policy coverage and insurance limits to determine claim eligibility and ensure compliance with coverage conditions.
- Liaise with hospitals and relevant stakeholders to facilitate efficient claim processing.
- Evaluate and approve claims in adherence to the established Service Level Agreement (SLA).
- Perform additional duties as assigned to support operational efficiency.
Qualification
- Relevant tertiary qualification in Nurse Science, Medical Technology or a related field
- At least 1-2 years of experience as a Claim Assessor or experience in the insurance industry or nursing knowledge will be given special consideration.
- Detail-oriented and responsible for assigned tasks.
- Proficient in computer skills, with a strong command of MS Office.
- Strong communication skills, ability to work under pressure, service-minded, and highly responsible.
- Professional demeanor, excellent interpersonal skills, integrity, diligence, perseverance, and a positive attitude.
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