Lowongan Case Management Doctor (Medical Advisor) di PT Fullerton Health Indonesia

Fullerton Health Indonesia provides third-party administration (TPA) service, we assist insurance companies and corporate human resource departments in bridging their policyholders’ or employees’ claims with our nationwide and regional medical care providers. 

As a Doctor in the Case Management team, your responsibilities include:

• Proactively work with treating doctors to make sure patients are being diagnosed correctly and are receiving appropriate treatments promptly.
• Approval on medical cases as well as on the issuing of guarantee letters for clients.
• Ensure benefit payments are correctly made.
• Monitoring hospitalized patients from a distance.
• To assist any participants unsure of where to obtain appropriate treatment.
• Investigate symptom/indication claims with high medical costs
• Provide opinion and/or recommendation written on medical services including drug delivery upon request of participants involved
• Investigate claims to determine the medical conditions of participants in detail and monitor the case

* Note: Will not meet patients directly

Requirements:

• Medical Doctor (S1 Profesi Kedokteran), post-internship Doctors are welcome to apply
• Familiar with health insurance claim administration workflow/process
• Experienced in Medical Insurance or Third Party Administration Industry would be an advantage
• Communicative, strong team player, and a strategic thinker
• Proactive outside working hours
• Proficiency in English
• Work from Office (WFO), placement in head office TB Simatupang Cilandak, South Jakarta. Office Hours, Monday-Friday.