Senior Executive - PRUmedical Network Operations

PLA PT Prudential Life Assurance (Indonesia) (Jakarta JK, Indonesia) 10 days ago

At Prudential, we understand that success comes from the talent and commitment of our people. Together, we have a shared vision in securing the future of our customers and our communities. We strive to build a business that you can shape, an inclusive workplace where everyone’s ideas are valued and a culture where we can thrive together. Our people stay connected and tuned in to what’s happening around us, keeping us ahead of the curve. While focused on the long-term, we look to the future to bring growth, development and benefit to everyone whose lives we touch.

1. Manage team, monitor and to ensure that that following processes in his/ her team are in
place, made 100% accurate and according to following service level timeline:
a. Letter of Guarantee issuance is maximum 30 minutes.
b. Guarantee of Payment issuance is maximum 45 minutes.
c. Patient case monitoring activities are implemented for all patients daily.
d. Inpatient Claim adjudication, an inpatient claim is done in maximum 12 minutes,
outpatient claim is done in maximum 7 minutes.
2. To manage and ensure the team is manned efficiently by carefully proposing shifts and
schedules to Assistant Manager and by closely monitoring attendance schedule.
3. To ensure that daily interim bill is communicated to related parties.
4. To ensure that the function adhere to policy condition, by performing quality assurance in
his/ her team activities and by giving regular coaching.
5. To ensure that all teams are efficient and sufficiently manned, by performing workload
and staffing balance in his/ her team every day.
6. To ensure that no backlog in his/ her team processes by monitoring dashboard.
7. To ensure that problem prompt escalation to supervisor is real time, by giving prompt
response to an escalation.
8. To do regular reporting to supervisor in timely manner
9. To maintain clear communication and warm relationship to all related parties.
10. To give decision on approving / disapproving preauthorization requests and discharge
planning requests or case monitoring approval requests, or claim settlement requests.
11. To ensure that all communications to customers, agents, partners, and other department
staffs are made politely and correctly.

Senior Executive - PRUmedical Network Operations

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