Junior Nurse Claim Assessor
KSK Insurance Thailand
Bangkok
03 Jan 2023

Challenge yourself and unleash your potential with us!

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We believe in the human potential. Essentially our business is the business of people, with people, whether they are just entering the job market or an industry veteran. We are always seeking for motivated, ambitious and diligent individuals to join our team of professionals.

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At KSK Insurance, we aim to do everything we can to provide high-quality, dependable, thorough service. This commitment to excellence is a promise our customers and partners have the right to expect. From purchasing a policy to renewing it to invoking all the benefits it has to offer, our aim is to put you at the center of everything we do.

Everyday…

  • Daily monitoring of all medical / travel claims
  • Manage the expectation of customers in line with the Company’s direction
  • Verifying claims documents vs policy terms & conditions to ensure the genuineness of the claim within policy coverage
  • Coordinate between customers, brokers, service providers to ensure excellent service
  • Coordinating with A&H team for a 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 the appropriate price
  • Flag irregular/fraudulent/exaggerated claims to superior for further action
  • Liaising with hospitals with a view to eliminating unnecessary or irrelevant treatment, overservicing, over-charging and cost-containment
  • Evaluating customer’s condition and arranging proper assistance to the claimant
  • Handling e-mail & all communication channels within the targeted timeline
  • 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, maintaining compliance with laws & regulations within the A&H team
  • Any other task/responsibility assigned by superior

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Your will need to…

  • Fresh graduated or Minimum 1 year in nursing experience and/or life or health insurance company
  • Able to work in a 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
  • Willing to learn and Can Do attitude
Apply now
Apply now
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