Nurse Claim (พยาบาลพิจารณาสินไหม) - Ocean Life Insurance

Position: Nurse Claim (พยาบาลพิจารณาสินไหม)

Responsibilities:

• Document Verification: Verify claim documents via fax/email for correctness and completeness

• Claims Assessment: Examine policy status, coverage conditions, exclusions, and approve claims within authorized limits

• Medical Knowledge Application: Record data and screen for medical necessity in patient care

• Coordination & Follow-up: Coordinate and follow-up with documents/additional information from internal and external units, and network hospitals

• Documentation & Communication: Log review history and communicate approval decisions to policyholders and stakeholders

Qualifications

Required:

• Bachelor's degree in Nursing, Public Health, or related field
• Strong coordination and communication skills (insurance experience valued)
• Responsibility and ability to manage multiple tasks systematically
• Basic data analysis and reporting capabilities
• Openness to learning new technologies, including AI tools for workflow improvement