Bangkok, Thailand · Hybrid
Job Description: Concurrent review and utilization management Daily perform concurrent review of patient’s clinical information from hospital network to ensure appropriateness of care are in accordance with policy …
Skills: Concurrent Review, Utilization Management, Case Management, Clinical Review, Discharge Planning
Bangkok, Thailand · On-site
Eastspring is a global asset manager with Asia at its core. We create a culture in which diversity is celebrated and inclusion assured, for our colleagues, customers, and partners. We provide a platform for our people to…
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Bangkok, Thailand · On-site
Job Summary Manage and Control all related document for support contracts of Operation and SAP. Mange all issue of collection and communication with client/tenant to ensure completely payment on time according to company…
Skills: SAP, Accounts Receivable, Revenue Billing, Financial Documentation, Collection Management
Bangkok, Thailand · Hybrid
Main Purpose of the Role The People Officer is responsible for executing key HR operational functions, including HRIS updates, learning & development coordination, employee relations & engagement, onboarding and recruitm…
Skills: HR Operations, Learning & Development, Employee Relations, Recruitment, HRIS Management
Bangkok, Thailand · On-site
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Bangkok, Thailand · On-site
Want to make a positive difference to the future of people and our one shared home, the Earth? Working at WWF could be your opportunity of a lifetime. All around the world, people are waking up to the devastating impacts…
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Bangkok, Thailand · On-site
Company Description Join a hotel that is a member of the Accor network, whose group brings together more than 45 brands, 5,500 hotels, 10,000 restaurants and lifestyle destinations. Here, we believe in you and what you b…
Skills: Sales Coordination, Administrative Support, Client Communication, Documentation Management, Hospitality Operations
Bangkok, Thailand · On-site
About the Company As a global medical device company originating from Japan, we pursue reliable quality and technology to contribute to healthcare in more than 160 countries and regions around the globe. We promise to wa…
Skills: Inventory Control, Warehouse Operations, Logistics, Supply Chain Management, Customer Service
Bangkok, Thailand · On-site
Objective To achieve sales goals and corporate Straumann Group business objectives of Thailand for all our therapies To promote full range of company products in territory through local distribution network and execute s…
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Bangkok, Thailand · On-site
About the Company As a global medical device company originating from Japan, we pursue reliable quality and technology to contribute to healthcare in more than 160 countries and regions around the globe. We promise to wa…
Skills: Demand planning, Supply chain management, Inventory management, S&OP process, Forecast accuracy
Bangkok, Thailand · On-site
About the Company As a global medical device company originating from Japan, we pursue reliable quality and technology to contribute to healthcare in more than 160 countries and regions around the globe. We promise to wa…
Skills: Marketing support, Event planning, Webinar coordination, Marketing asset creation, Invoice management
Bangkok, Thailand · On-site
About the Company As a global medical device company originating from Japan, we pursue reliable quality and technology to contribute to healthcare in more than 160 countries and regions around the globe. We promise to wa…
Skills: Tender management, Public procurement, Government tender processes, Document management, Compliance
Bangkok, Thailand · On-site
About the Company As a global medical device company originating from Japan, we pursue reliable quality and technology to contribute to healthcare in more than 160 countries and regions around the globe. We promise to wa…
Skills: Supply chain planning, Demand forecasting, Inventory management, SAP, PowerBI
Bangkok, Thailand · Hybrid
Support Consultants’ coordination with government and non-government stakeholders in the fields related to clients’ issues Supports 2-3 Vero Advocacy’s public policy clients on policy research, policy and regulatory anal…
Skills: Policy Research, Regulatory Analysis, Media Monitoring, Stakeholder Outreach, Drafting Deliverables
Bangkok, Thailand · On-site
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Bangkok, Thailand · On-site
Seaplane Asia is looking for interns for the following departments: Partnerships & Business Development, Operations, Finance, and Marketing. Other specific areas may also be open for consideration. The internships are ac…
Skills: Social Media Management, Financial Reporting, Market Research, Data Analysis, Administrative Support
COSDENTBangkok, Thailand · On-site
$28k–$38k/mo
Reception Team Lead เป็นตำแหน่งสำคัญของ Cosdent ที่ดูแลประสบการณ์ผู้ป่วยตั้งแต่การติดต่อครั้งแรก การนัดหมาย จนถึงการให้บริการที่หน้าคลินิก ตำแหน่งนี้มีหน้าที่ควบคุมทีม Reception เพื่อให้การสื่อสารกับลูกค้าเป็นไปอย่างมืออ…
Skills: Communication, Multitasking, Team Leadership, Appointment Scheduling, Customer Service
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Perform concurrent reviews of patient clinical information to ensure appropriateness of care and coordinate discharge planning to optimize length of stay. Develop and improve claim SOPs, monitor team performance, and manage relationships with hospitals to facilitate cashless claim journeys.
Requires a Bachelor's degree in nursing with 2-3 years of experience in UR or ICU/ward nursing. Preference is given to candidates with at least one year of experience in health claims within the insurance industry.
Job Description:
Concurrent review and utilization management
Daily perform concurrent review of patient’s clinical information from hospital network to ensure appropriateness of care are in accordance with policy terms and conditions.
Reviewing patients’ medical records to identify errors or missed diagnoses that could have been detected earlier in treatment or unnecessary investigation and treatment.
Coordinates patient’s discharge planning with UR or UM physician for ongoing case to ensure appropriate length of stay.
Analyze a situation and able to make decision based on the receive information whether a patient is ready to be discharged from the hospital.
Seek consultation from appropriate disciplines/departments as required to expedite claim decision and facilitate timely and accurate communication of claim decision and clinical reviews before discharge.
Refer case issues to team advisor(s) in a timely manner and monitor the issue until it is resolved.
Prepare monthly the Utilization Management and cost savings report in area responsibility.
Keep close monitoring claim TAT to ensure all cases could be completed within SLA.
Deliver service with a strong focus on customer satisfactions.
Build strong relationship with hospital to contribute the smoothly cashless claim journey.
Support peers in the aspect of holistic health claim management.
Ensure the correctness of claim data capturing.
Assist in manage team daily performance
Process improvement
Develop trusted relationships with involved parties – listen actively to their concerns and questions to better understand their requests and perspectives.
Participate in the overall improvement efforts of the Project Management team by seeking opportunities for feedback and development.
Revisit the current process and define the improvement then identify quick win solution.
Quality and cost efficiency controls
Supporting internal control tools and internal audit program for team to determine the appropriate claim authority and performance evaluation aspect.
Help develop work instruction, guideline for hospitals and claim SOP to increase effective resolution of all claim inquiries.
Establish the process of checks and balances.
Provides the stakeholder the feedback that related to their performance such as early claim case.
Assist in develop SOP, Workflow and procedure and effectively communicate to team.
Timely report the significant incident with immediately action, short term solution and preventive action.
Timely provide regular and ad hoc report.
People development
Develop multiple skills that will support team and company goal.
Report and solve the problem and regular feedback with team.
Monitor and encourage team to participate self-learning.
Assist in providing training to the other concerned parties such as CCC, distributors.
Qualifications:
Bachelor's degree in nursing
At least 2-3 years of experience in UR Nurse or Nurse ward/ICU in hospital
At least 1 year of working experience in Life or non-Life Insurance and Health Claims is preferred
Previous training and demonstrated competence in negotiation, quality assurance, case management outcome
Capable to communicate in both writing and speaking English
Negotiate and handle issues with external and internal parties
About Krungthai-AXA Life Insurance
Krungthai-AXA Life Insurance Public Company Limited, created from a solid co-investment partnership between Krungthai Bank PCL. and the AXA Group, global financial protection and asset-management specialists.
The trademark of Krungthai-AXA Life Insurance is designed to indicate the combination of the two corporations. Krung Thai Bank PCL. and AXA Group logos are aligned with Thai characters displaying the company name as Krungthai-AXA Life Insurance placed above the red line and the new company signature. Redefining/Life Insurance.
Today Krungthai-AXA Life Insurance Public Company Limited is a fast-growing life insurance company with a vision – Ambition AXA.
Our Perks and benefits
As one of the largest global insurers, our purpose is to act for human progress by protecting what matters. Protection has always been at the core of our business, helping individuals, businesses and societies to thrive. And AXA has always been a leader, an innovator, an entrepreneurial company, fostering progress in all its dimensions. Our purpose also links back to the Group's roots. From the outset, AXA has been committed to acting as a force for collective good. From solidarity-based actions with AXA Hearts In Action to work on prevention issues with the AXA Research Fund and the fight against climate change, AXA has always been attentive to its social environment and embraced its responsibility as an insurer: responsibility for taking action upstream in order to better understand risks, with one goal in mind: to ensure better protection. Discover more: https://www.axa.com/en/about-us/our-purpose To know more about AXA's Privacy Policy - https://www-axa-com.cdn.axa-contento-118412.eu/www-axa-com/1cd44dfb-3b7a-4cf7-933b-06024cf7f25b_axa_privacypolicy_internetusers_va.pdf
Offices: 25, avenue Matignon, Paris, FR 75008, FR
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