Internal Verificator

siloamcareers· Network Operations
Apply Now ↗
📍 Cikarang, Jawa Barat📍 Cikarang, Jawa Barat, , Indonesia📍 idFull time

About this role

Company Description

Job Description

•Manage the submission and reimbursement of BPJS claims as well as lead Coders (OPD and IPD) and review their work to ensure claim submission and coding optimization is complete and on time.

•Check the completeness of the documents required to submit a claim.

•Communicate with Specialists, Front Office and Coders for any changes to claim documentation.

•Review coding input and hospital billing details in accordance with INA-CBG carried out by Coder.

•Ensure that claims submitted are in accordance with the specified patient care class.

•Monitor and manage the list of claims that have not received feedback from BPJS, as well as the reimbursement status of claims that have received feedback from BPJS via Finance.

•Obtain information from Finance and collect additional documents as required by BPJS and/or related explanations required within 3 working days.

•Collaborate with Finance and medical teams (e.g. Casemix Manager, Specialist, RMO) as well as BPJS to resolve issues related to pending/disputed/inappropriate claims.

•Monitor the reasons for pending/disputed/inappropriate claims and periodically develop BPJS SOPs.

•Communicate with Casemix Manager regarding clinical practices that can assist in optimizing the number of claims.

•Provide the latest information to the BPJS team (both clinical and administrative staff) regarding developments or updates in BPJS regulations.

•Ensure compliance with BPJS regulations and prevent fraud cases

•Support the BPJS internal team (including Front Office, Coders, etc.) in implementing digital verification (“VEDIKA”) in units

•Building good working relationships with BPJS verifiers

•Bachelor Degree from Healthcare Administration, Health Information Management, Accounting, or any related major

•Healthcare Administration, Health Information Management, Accounting, or any related major

•Have minimum 2 years working experience in the field of BPJS operations.

•Have strong analytical skills to review and interpret complex data and identify discrepancies.

•High attention to detail to ensure accuracy in auditing and verification processes.

•Understanding of internal controls and best practices for ensuring data accuracy and operational efficiency.

 

 

 

 

 

Qualifications

•Bachelor Degree from Healthcare Administration, Health Information Management, Accounting, or any related major

•Have minimum 2 years working experience in the field of BPJS operations.

•Have strong analytical skills to review and interpret complex data and identify discrepancies.

•High attention to detail to ensure accuracy in auditing and verification processes.

•Understanding of internal controls and best practices for ensuring data accuracy and operational efficiency.

 

 

 

 

 

Additional Information

[BEWARE OF RECRUITMENT SCAMS]

It has come to our attention that there are fake job offers claiming to be hiring for Siloam Hospitals Group. Please note that Siloam Hospitals Group do not require applicants to make payment when seeking employment with our hospitals.

Frequently Asked Questions

Is the salary disclosed for the Internal Verificator position at siloamcareers?
The salary for this Internal Verificator role at siloamcareers is not publicly listed. Click "Apply Now" to learn more about the compensation package on their official careers page.
Where is the Internal Verificator position at siloamcareers located?
This Internal Verificator role at siloamcareers is based in Cikarang, Jawa Barat, Cikarang, Jawa Barat, , Indonesia, id. The position is listed as on-site or hybrid. Check the full job description or apply directly to confirm the work arrangement.
Is the Internal Verificator role at siloamcareers full-time or part-time?
This is listed as a Full time position. It is posted as a Internal Verificator role in the Network Operations department at siloamcareers.
Which team or department does the Internal Verificator at siloamcareers belong to?
This Internal Verificator position is part of the Network Operations department at siloamcareers. See the full job description for more information about the team structure and responsibilities.
How do I apply for the Internal Verificator position at siloamcareers?
Click the "Apply Now" button on this page. You will be redirected to siloamcareers's official application portal hosted on smartrecruiters where you can submit your application directly.
When was the Internal Verificator job at siloamcareers posted?
This Internal Verificator position at siloamcareers was posted on Jul 25, 2025. Apply as soon as possible — early applications are often reviewed first.
Internal Verificator
siloamcareers
Apply for this role ↗

You'll be redirected to siloamcareers's official application page on SmartRecruiters.