• Responsible in performing technical and medical audit on uploaded claims and ensure an appropriate application of policy and tariff agreements.• System processes includes claim reception, medical assessment, pricing and audit, and closing.• Coding Standard: ICD-10-AM/ACHI/ACS• Systems Softwares: I-geme, I-care, Cognos, PICQ,

• Responsible in performing technical and medical audit on uploaded claims and ensure an appropriate application of policy and tariff agreements.• System processes includes claim reception, medical assessment, pricing and audit, and closing.• Coding Standard: ICD-10-AM/ACHI/ACS• Systems Softwares: I-geme, I-care, Cognos, PICQ,

• Evaluate claim documentation for quality, completeness and code consistency, reviewing the information and deciding if the claim is eligible for payment in accordance with the organization's policies and procedures (Direct, OP/IP consultation, pharmacy, physiotherapy, and laboratory services and reimbursement).• Process claim forms, adjudicates for provision of deductibles, co-pays, co-insurance and provider settlements• Ensure compliance with all coding mandates and regulations.

• Entry and processing (edit/entry) medical direct and reimbursement claims through in-house data software, done with soft documents. Ensuring the data are properly and accurately entered and adjudicated.

• Task to monitor, document, and implement standards as adhered to mandatory government regulation and international policy(QMS 2001: SA 8000), includes custody of documents and document control.• Assist in the developing and updating of company policy and procedure)• Facilitates, organizes, and coordinates training and awareness.• Perform basic clerical skills.• Serve as officer-in-charge of Occupational Safety and Health• Carry out basic secretarial duty to the office of the Plantation Manager.