Leader Case Management English Speaker (Nurse/Midwife)

Fullerton Health Indonesia provides third-party administration (TPA) service, we assist insurance companies and corporate human resource departments in bridging their policyholders’ or employees' health claims with our nationwide and regional medical care providers. As a Leader Case Management / Call Center English Speaker (Nurse / Midwife), your responsibilities include the:

• Responsible for all incoming communications via phone calls including answering any questions regarding information about providers, hospital payments, benefit limits, etc. from the insured person

• Receive medical information directly from the hospital and check the data on patient participation, pre-existing condition, date joined, including the exception of diagnosis or not, excess charge, and a decision whether the warrants will be issued, rejected, or be investigated first

• Issuing letters of guarantee for inpatient care, dental care, Medical Check Up (MCU), Optical and One Day Care (ODC)

• Answering e-mails both internally and externally in the form of good corporate complaints, information, or confirmation

• Confirmation by E-mail or phone if the diagnosis of patients included in the advice only, or listing investigation by the client

• Monitoring patients based on the patient's progress, the results of the investigation, analysis of whether the treatment is done following the medical indications, as well as investigating if there is prolonged care or other hi requiring investigation, updating your billing information, and decide whether to continue underwriting, terminated or modified

* Note: Will not meet patients directly 

Requirements:

• Candidate must possess at least a Diploma in Nursing or Midwifery

• Willing to work in shifting hours (morning, afternoon, night) including weekend/public holiday

• Must be fluent in English, both written and spoken

• Have good medical knowledge

• Having experience in TPA/insurance/claim or other healthcare field is highly preferred

• Computer literate

• Willing to be placed in Head Office in South Jakarta

• Able to join at the soonest
  

*only accepting Nurse or Midwife candidates