Ruth S.
Senior Health Insurance Claim Analyst
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Ruth N. is an experienced claims analyst with over 14 years in the health insurance sector, currently employed with Asuransi Jiwa Astra. Her tenure from March 2011 to the present has equipped her with a comprehensive skill set in reviewing and processing insurance claims, ensuring the submission's completeness, and recommending approval or denial based on established company standards. She exhibits a keen ability in handling customer requests and complaints, achieving optimal solutions through teamwork and coordination. Ruth is adept in identifying and addressing potential fraud by collaborating with the risk management team. Her technical proficiency includes Microsoft Excel, Microsoft PowerPoint, and knowledge of Anti-Money Laundering regulations and Consumer Protection. With a Diploma III from Akper RSU Universitas Kristen Indonesia, completed in 2010, she brings a solid educational foundation to her highly detail-oriented role.
Experience
Claim Analyst Staff
Astra Life Insurance · 2011 — PresentReviewed and processed health insurance claims, ensuring the completeness of documentation including expense receipts, and made recommendations for claim approval or rejection based on company standards. Coordinated with TPA to analyze claim statuses and medical histories of participants. Responded to customer inquiries and complaints, collaborating with relevant teams to find optimal solutions. Investigated claims with potential fraud indications and coordinated with the risk management team in the event of fraud detection. Worked with the team to maintain productivity and quality of work according to established company standards.
Skills & Expertise
Education
- Diploma IIIAkper RSU Universitas Kristen Indonesia · — — 2010