สมัครงานบริษัท PT. Prima Sarana Jasa | ทุกตำแหน่ง

PT. Prima Sarana Jasa

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QA Supervisor (TPA Insurance)

PT. Prima Sarana Jasa

อินโดนีเซีย | DKI Jakarta

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Claim Assessor (Medical Doctor)

PT. Prima Sarana Jasa

อินโดนีเซีย | DKI Jakarta

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QA Supervisor (TPA Insurance)

PT. Prima Sarana Jasa

PT. Prima Sarana Jasa (South Jakarta, Jakarta)

DKI Jakarta, อินโดนีเซีย

Global Excel in Indonesia (PT Prima Sarana Jasa) is a third-party administrator (TPA) with over 2 decades of experience in the Indonesian healthcare market. As a Global Excel family member, we can support our clients with their growth needs. Global Excel provides payers with a consultative approach to cost-effective, quality care programs through a single partnership. We deliver seamlessly tailored solutions 24/7 through our customer service and medical professionals by providing access to our network of certified healthcare facilities, ensuring highly effective cost containment.

คลิกเพื่อดูงานที่คล้านกันในประเทศ อินโดนีเซีย:

ฝ่าย: การจัดการคุณภาพ

อุตสาหกรรม: การจัดการและการให้คำปรึกษา การดูแลสุขภาพและการแพทย์

เกี่ยวกับตำแหน่งนี้

The QA Supervisor (TPA Insurance) is responsible for ensuring the quality and compliance of claims processing through audits, training, and collaboration with various teams.

หน้าที่รับผิดชอบ

• Conduct regular audits of claim files to ensure compliance with company guidelines, insurance policies, and regulatory requirements.
• Develop and implement QA procedures for claims processing to ensure accuracy, consistency, and timeliness in the settlement of claims.
• Monitor and evaluate the performance of the claims team through KPIs such as processing accuracy, customer satisfaction, and turnaround time. Provide feedback and training where necessary.
• Ensure all claims processing activities adhere to regulatory standards, mitigating any potential risks through early detection of compliance gaps.
• Analyze QA reports and provide insights to senior management on claims trends, areas of concern, and improvement opportunities.
• Train and mentor the claims team on QA standards, ensuring they are up to date with policies, procedures, and best practices.
• Collaborate with claims adjusters, customer service, and IT teams to streamline the claims handling process and implement new technologies or procedures to enhance efficiency.
• Monitor customer feedback related to claims processes, identify recurring issues, and recommend solutions to improve service quality.
• Work with the claims and customer service teams to investigate and resolve complex claims issues or complaints, ensuring timely and satisfactory resolutions.

คุณสมบัติ

• 3-5 years of experience in claims handling, quality assurance, or supervision, preferably in a TPA or insurance company.
• Bachelor’s degree in insurance, business administration, or a related field.
• Strong knowledge of claims processing and TPA insurance operations.
• Strong written and spoken English and Bahasa Indonesia.
• Familiarity with local and international insurance regulations and compliance standards.

สิทธิประโยชน์

Huneety A.I Salary Estimate

9,000,000 - 26,000,000 IDR per month

About PT. Prima Sarana Jasa