Nurse Claim Assessor

6 days ago


กรงเทพมหานคร, Thailand Sunday Insurance Full time

Daily monitoring of all medical / travel claims
- Manage the expectation of customers in line with Company’s direction
- Verifying claims documents vs policy terms & conditions to ensure genuineness of

claim within policy coverage
- Coordinate between customers, broker, service providers to ensure excellent service
- Coordinating with A&H team for medical opinion and claim approval & ensure targeted

turnaround time is achieved
- Performing medical contact to gather information from hospitals/medical center
- Explaining medical problems to patients or their families
- Reviewing the treatment provided by hospitals is relevant to the case and in

appropriate price
- Flag irregular/fraudulent/exaggerated claims to superior for further action
- Liaising with hospitals with a view to eliminating unnecessary or irrelevant treatment,

over-servicing, over-charging and cost-containment
- Evaluating customer’s condition and arranging proper assistance to claimant
- Prepare weekly reporting on TAT, outstanding & repudiated cases
- Keep abreast of medical knowledge, policy terms & conditions and coach/mentor the

A&H team
- Auditing claims to determine the accuracy of approvals made, the completeness of

the documentation for each record according to appropriate policies and procedures

and proper medical billing, maintain compliance with laws & regulations within A&H

team.
- Any other task/responsibility assigned by superior

**Qualification**
- Minimum 3 years in nursing experience and/or life or health insurance company
- Able to work in commercial environment and fast moving business
- Good interpersonal and communication skills
- Computer literacy is essential
- Self-motivated, result oriented, ability to work under pressure, creative and energetic


  • Nurse Assessor

    2 weeks ago


    กรุงเทพมหานคร, Thailand Sunday Insurance Full time

    **Everyday you will...** - Daily monitoring of all medical claims. - Manage the expectation of customers in line with Company’s direction - Verifying claims documents vs policy terms & conditions to ensure genuineness of claim within policy coverage - Coordinate between customers, service providers to ensure excellent service - Coordinating with Accident &...


  • กรุงเทพมหานคร, Thailand AXA thailand Full time

    **Assistant Nurse Claim Manager (Concurrent & Claim Investigation)** The role is responsible for managing and optimizing the cost-effectiveness of claims through effective utilization management strategies, conducting thorough claim investigations, and ensuring compliance with company policies and industry standards. This role involves reviewing and...

  • Claims Assessor

    2 weeks ago


    กรุงเทพมหานคร, Thailand FWD Life Insurance PCL Full time

    Assess and approves wit respect to new incontestable health and accident claim cases regarding the given authority. Facilitate the recommendation to higher authority assessor. Captures the claim information and benefit payment into the system as required to ensure the accurate payment to the claimant. Monitor and take action on self pending of claim ever 15...

  • Claim Assessor

    6 days ago


    ดินแดง, กรุงเทพมหานคร, Thailand Thai Life Insurance Public Full time

    **Claim Assessor**: สมัครตอนนี้ » **วันที่**:8 ต.ค. 2567 **ตำแหน่งที่ตั้ง**: ไทยประกันชีวิต สำนักงานใหญ่, TH **บริษัท**:Thai Life Insurance...

  • Nurse Coordinator

    2 weeks ago


    กรุงเทพมหานคร, Thailand April Asia Pacific Full time

    For over 30 years, APRIL International Care has been specializing in international health insurance solutions. We design, distribute, and manage insurance plans and assistance services for individuals and businesses. With teams across Asia, Europe, and the Americas, we look after our members wherever they are to make sure they have access to the best...

  • Claims Assessor

    2 weeks ago


    ปทุมวัน, กรุงเทพมหานคร, Thailand FWD Life Insurance PCL Full time

    Assess and approves with respect to both new and referred claim cases include special request regarding the given authority. Capture the claim information and benefit payment into the system as required to ensure the accurate payment to the claimant. Monitor and take action on self pending of claim every 15 days. Participate into system & process improvement...

  • Travel Claims Assessor

    18 hours ago


    กรุงเทพมหานคร, Thailand กลุ่มแอกซ่า Full time

    **JOB**: **The incumbent is responsible for handling end to end travel claims handling process covering receiving and registering claims, investigating claims, processing payment to customers and clarifying customers on claims’ status as well as decisions.**: **QUALIFICATION**: - **At least 2 years of Travel Insurance Experience**: - **Well-rounded TA...


  • กรุงเทพมหานคร, Thailand April Asia Pacific Full time

    To sustain the growth of the company as well as the expansion of our services we are currently looking for a Claims Administrator with a focus on Letter of Guaranty emission. Your role will be essential to provide peace of mind to our clients and accompany them in complex situations. Customer-centric and proactivity are a must. Your main responsibilities...


  • กรุงเทพมหานคร, Thailand Prudential Full time

    Prudential's purpose is to help people get the most out of life. We will deliver our purpose by creating a culture in which diversity is celebrated and inclusion assured, for our colleagues, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and in exchange, we support our people's career...


  • กรุงเทพมหานคร, Thailand April Asia Pacific Full time

    For over 30 years, APRIL International Care has been specializing in international health insurance solutions. We design, distribute, and manage insurance plans and assistance services for individuals and businesses. With teams across Asia, Europe, and the Americas, we look after our members wherever they are to make sure they have access to the best...