12 พฤศจิกายน 2562
รหัสงาน: BK-149842
เจ้าหน้าที่พิจารณาสินไหมทดแทน(Claim)

Responsibility:

  • Reviewing pre-certification and prearrangement requests for medical necessity.
  • Reviewing medical records and clinical information for concurrent reviews to determine benefit coverage including approvals or denials for length of hospital stays and for durable medical equipment, physical therapy.
  • Conducting initial, concurrent and retrospective review of inpatient admissions and telephonic reviews to support the need for admission and/or extension of inpatient stay.
  • Consulting with consultant doctor on cases with inconsistencies prior to final approval or denial.
  • Managing and preparing monthly claim report for cost savings and management reports such as pharmacy control and stop loss report.
  • Conducting void process in parts of claims and summarize medical record to propose to void committee.
  • Performing additional responsibilities as required by Operations Head Department.

Qualifications: 

  • Bachelor's degree in Nurse, Medical Science. 
  • At least 3-5 years experience in claim assessment or medical services in insurance business industry.
  • Good knowledge of claims decision and the ability to analyse information accuracy.
  • Good team working skills and the ability to collaborate effectively with others.
  • Being able to grasp clinical issues, including the understanding of treatments and evolving medical technologies. 

 

Human Capital & Support Department
Generali Life Assurance (Thailand) Public Co., Ltd.


87/2 CRC Tower, All Seasons Place 16th Floor,
Unit 1602 – 1605, Wireless Road, Lumpini,
Patumwan, Bangkok 10330
Tel: (662) 685 3828 Fax: (662) 685 3621

For further details please contact as
Web site : 
http://www.generali.co.th

 


รายละเอียดงาน:

สวัสดิการ
  • ทำงานสัปดาห์ละ 5 วัน
  • เงินโบนัสตามผลงาน
  • ค่ายานพาหนะ
  • ประกันสุขภาพ
  • สิทธิการเบิกค่าทันตกรรม
  • ประกันชีวิต

Generali Life Assurance (Thailand) PCL.
https://generali.co.th/en/
The Generali Group is one of Europe’s biggest insurers by market capitalization and it ranks in the top five insurers in the world by global premium income. Generali employs over 60,000 employees worldwide. Generali Thailand provides competitive remunerations and employee benefits in line with multinational operating in Thailand. We are committed to investing in a comprehensive training and development program for our staff. Now we are seeking for competent, enthusiastic and qualified candidates for the following vacancies:

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