Mobile Developer Application Medilink
We are actively developing Southeast Asia's top TPA, which makes it easier for consumers to obtain insurance. To achieve our objectives, we therefore require talent with great potential, like you, to join our expanding organization, acquire the necessary skills, and also form outstanding teams.
Responsibilities
- Review, analyze, and process medical and insurance claims in accordance with company policies, service agreements, and benefit plans.
- Verify completeness, accuracy, and eligibility of claim submissions, ensuring compliance with standard procedures and contractual terms.
- Evaluate medical documents, coding accuracy (ICD, CPT, or equivalent), and supporting evidence to validate claim legitimacy.
- Coordinate with internal teams, providers, and insurers to resolve discrepancies and ensure timely adjudication.
- Identify potential fraud, abuse, or inconsistencies in claim data and escalate as needed.
- Support digital claims processing using Medilink's Electronic Claims Clearing System (ECCS 5.0) and maintain accurate claim records for audit and compliance purposes.
- Contribute to workflow improvements and efficiency initiatives within claims operations.
Qualifications
- Bachelor's degree in Insurance, Healthcare Administration, Nursing, or a related field.
- Experience in claims processing, healthcare insurance, or TPA environment.
- Strong understanding of medical terminology, health benefit structures, and insurance claims workflows.
- Proficiency in MS Office (especially Excel) and comfortable working with digital systems or claim management software.
- Good communication and interpersonal skills for effective collaboration with internal and external stakeholders.
About MEDILINK DIGITAL MEDIKA
PT Medilink Digital Medika has established a strategic and technological collaboration with Medilink-Global Asia Pte Ltd. Through this collaboration, the company shall enjoy the exclusive rights of use of the bespoke Electronic Claims Clearing System (ECCS 5.0), a time-tested and proven solutions which have been implemented successfully and are functioning effectively at insurance companies and TPAs in several countries. The collaboration also allows the company to gain immediate access to Medilink-Global's international network of health care providers.
Our vision is to be the Preferred Employee Benefit And Health Insurance Management Portal in Indonesia, offering anytime-anywhere Medical Claims Management Tools that connect the Payors, Healthcare Providers and Members.
Our mission is we provide connected Digital Solution for Insurance Companies and Corporates. Enabling them to offer their Members Seamless Access to Quality & Equitable Healthcare at Domestic and Regional Health Facilities.
Medilink is committed not only to make insurance easily available for everyone but also to spread awareness about the importance of having financial plans and protection through insurance.
More About MEDILINK DIGITAL MEDIKA
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