Medical Case Assessor (LOG)
About the team
Doctor Anywhere's Operations team is a crucial part of the company. We ensure the day-to-day excellence of our TPA business, virtual and in-person clinical services, resolving operational issues in a timely manner and providing the best customer experience possible. We make sure that our customers remain our top priority
About the role
We are seeking a Medical Case Assessor who will assess inpatient case assignments to recommend approval or decline of Letter of Guarantee/Pre-authorization requests. The ideal candidate will have a mindset of continuous improvement and change and will demonstrate curiosity, collaboration and the ability to deal with ambiguity especially in a start-up environment.
This role reports directly to the Team Lead, Medical Case Assessor.
A summary of the key responsibilities are as follows:
- Assess inpatient case assignments and recommend your decision to approve or decline Letter of Guarantee or pre-authorization requests.
- Work closely with Specialists, Clinics and Hospital groups in relation to the Letter of Guarantee or pre-authorization requests.
- Ensure any suggested treatment plans fall within policy terms and conditions.
- Maintain accurate case records and all related communication.
- Be exposed to data analytics tools as part of your assessment work.
- Any other special projects and ad-hoc duties assigned when appropriate.
About you
- Diploma/Degree, preferably within studies of Bio-sciences, Nursing or Statistics.
- Experience in Healthcare/Insurance/Third-Party Administrators industries is a must.
- Ability to communicate clearly in both writing and verbally.
- Ability to handle and mediate sensitive issues calmly, empathetically and professionally.
- Proficient in Microsoft Office applications.
- A start-up attitude - you take full ownership of things that you do, willing to go out of your comfort zones and take on new challenges.
- Comfortable with ambiguity - we are a fast-growing business and there's always unchartered territories, which is part of the fun. You should be comfortable with it and understand that not everything is 100% defined all the time.
About Doctor Anywhere
Doctor Anywhere (DA) is a regional tech-enabled, omnichannel healthcare provider delivering care to 2.5 million users across 6 countries in Southeast Asia. Founded in 2017 with a mission to make healthcare simple, accessible, and efficient for all, DA leverages technology to enable individuals towards preventive, long-term health via holistic offerings including our telehealth app, physical clinics and pharmacies, mental wellness, specialist consults, and also an online health & wellness marketplace for supplements, healthy snacks, home-based health screening and vaccinations.
DA’s goal is to build a regional digital healthcare ecosystem, advanced by the 3,000 GPs and specialists within our regional network, over 1,000 corporate organizations, and 25 regional insurers we work with. Grounded in our motto “Keep Going, Keep Growing”, our team strives towards excellence, with innovation and collaboration at our core, and values diversity in perspectives brought by every member. Join us in our mission to transform Southeast Asia’s healthcare future!
Not for you? We have other opportunities that may interest you or someone you know. Feel free to visit us at our careers page - https://doctoranywhere.com/job-listing/ for more information.