Claim Assessor (Assistant Supervisor)

  • Review and validate hospital billing documents 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.

Qualifications: Bachelor's degree in any field; candidates with at least 3 year of experience as a Claim Assessor, UR Nurse 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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