AWP Services (Thailand) Co., Ltd.

About Us: We are seeking a dedicated and detail-oriented Nurse Claims Assessor to join our team. In this role, you will be responsible for verifying claims, managing documents, and providing exceptional customer service. If you have a background in nursing and a passion for helping others, we encourage you to apply. We welcome applications from registered nurses with no prior claims experience. Verify the accuracy and completeness of claims. Send emails and faxes to confirm document receipt. Organize and manage all relevant documents efficiently. Prepare monthly reports and ensure all data is accurate before submission to customers. Professionally handle phone calls from customers and providers.

Responsibilities • Process and record the medical expenses under benefit claims • Verify Claim and Approve Claims • Ensure well filing documentation and agents’ work under the aspect of existing workflows, effectiveness and service level agreement • Check and prepare the correctness of information, required documentation given to customer • Check and validate to confirm of document receiving. • Perform other related duties and special projects as assigned. รายละเอียดของงาน • พิจารณาสินไหมทางการแพทย์และตอบข้อสอบถามจากโรงพยาบาลได้ตามมาตรฐานของบริษัท • ปฎิบัติงานได้สำเร็จตามเป้าหมายส่วนบุคคลที่วางไว้เพื่อบรรลุเป้าหมายของทีม • มีส่วนร่วมอย่างกระตือรือร้นในการตรวจดูผลการทำงาน รวมไปถึงการสอนและฝึกอบรมต่างๆของแผนก • แสดงความคิดเห็นและเสนอแนวคิดต่อหัวหน้าทีมเพื่อการปรับปรุงกระบวนการทำงานอย่างสม่ำเสมอ • ให้ความร่วมมือและมีความยืดหยุ่นต่อการจัดตารางการทำงานเพื่อตอบสนองความต้องการทางธุรกิจ • บันทึกข้อมูลเชิงคุณภาพของงานเพื่อความถูกต้องแม่นยำในการายงานข้อมูลของลูกค้าแต่ละคน • จัดทำรายงานและปฏิบัติงานอื่นๆตามที่ได้รับมอบหมายจากหัวหน้า • ปฏิบัติงานตามนโยบายบริหารความเสี่ยงและข้อกำหนดของบริษัท

Essential Job Functions: • Handle call and e-mail from customers and providers • Provide information according to insurance policy and claim enquiries • Coordinate and support claim assessor • Perform other duties and special assignments as required Work Conditions: • Working Hours : 40 hours per week • Working Days : Shift day and night, 5 days a week 07:00-16:00, 13:00-22:00, 22:00-07:00 • Flexible to work as shift, holidays, weekends. • Location : Head office

Job Summary: The Service Provider Coordinator is responsible for managing Network Services, including Home Assistance, Extended Warranty Appliance Protection, and Roadside Assistance. The role involves finding and managing new service providers, summarizing and monitoring service reports, and coordinating various Network projects to enhance business effectiveness. This position also requires coordinating with suppliers and providers, handling training, preparing reports, and managing documents as assigned by the Manager. Identify and recruit new service providers for Home Assistance, Appliance Protection, and Extended Warranty services. Support general network services such as Roadside Assistance. Prepare and dispatch service agreements and related documents (e.g., claim forms, uniforms) to providers. Evaluate provider performance, ensuring adherence to company standards. Coordinate with providers and related departments to resolve issues. Update and maintain provider information, ensuring accuracy in the system; prepare monthly, quarterly, and annual reports. Summarize service performance reports, contributing to the improvement of service delivery processes, profitability, and cost-efficiency. Expand and develop the service provider network to cover all required service areas. Manage provider costs to maximize efficiency. Undertake additional tasks and assignments as directed by the supervisor.

Coordinate with the client platform and providers. Monitor medical cases: Review the initial fax with instructions, notify the doctor immediately upon opening a new case, and inform the manager based on urgency. Ensure that providers deliver services on time and update the client platform while following their instructions. Control costs: Ensure costs do not exceed coverage limits, verify that expenses are relevant and reasonable, and check coverage details. Prepare quotations for the client platform as needed. Report any issues with cases to the Medical Leading Agent and Manager. Prepare daily, weekly, and monthly reports for the manager.