Client Resolution Specialist

Deskripsi pekerjaan

As a Client Resolution Specialist, you will act as the primary bridge between our prestigious clients (Insurance Companies and Hospitals) and our internal departments. Your mission is to ensure every client issue, ranging from technical glitches to complex fraud investigations, is resolved thoroughly and efficiently. You will perform deep-dive investigations to identify root causes and collaborate with internal stakeholders to implement long-term solutions.

Key Responsibilities:

• End-to-End Issue Management: Act as the central point of contact for high-level complaints from clients (Insurers & Healthcare Providers).
• Cross-Functional Investigation: Conduct thorough internal investigations involving various departments (IT, Claims, Medical, Legal, and Manpower) to pinpoint the source of operational or technical failures.
• Problem Solving: Analyze issues related to the healthcare application platform, claim disputes, potential fraud cases, and outsourced manpower performance.
• Root Cause Analysis (RCA): Identify systemic issues rather than just "fixing the symptoms" to prevent recurring complaints.
• Stakeholder Coordination: Lead meetings with internal department heads to negotiate solutions and ensure corrective actions are taken within the agreed SLA.
• Reporting: Prepare comprehensive resolution reports for both the client and management, detailing the investigation process, findings, and improvements implemented.
• Process Improvement: Provide strategic recommendations to management based on complaint trends to enhance overall service quality and client satisfaction.

Tanggung jawab

Key Responsibilities:

• End-to-End Issue Management: Act as the central point of contact for high-level complaints from clients (Insurers & Healthcare Providers).
• Cross-Functional Investigation: Conduct thorough internal investigations involving various departments (IT, Claims, Medical, Legal, and Manpower) to pinpoint the source of operational or technical failures.
• Problem Solving: Analyze issues related to the healthcare application platform, claim disputes, potential fraud cases, and outsourced manpower performance.
• Root Cause Analysis (RCA): Identify systemic issues rather than just "fixing the symptoms" to prevent recurring complaints.
• Stakeholder Coordination: Lead meetings with internal department heads to negotiate solutions and ensure corrective actions are taken within the agreed SLA.
• Reporting: Prepare comprehensive resolution reports for both the client and management, detailing the investigation process, findings, and improvements implemented.
• Process Improvement: Provide strategic recommendations to management based on complaint trends to enhance overall service quality and client satisfaction.

Kualifikasi

• Education: Bachelor’s Degree in Hospital Management, Public Health, Business Administration, Information Technology, or a related field.
• Experience: Minimum 3–5 years of experience in Client Relations, Quality Assurance, Case Management, or Operations, preferably within the Healthcare, TPA, or Insurance industry.
• Analytical Thinking: Exceptional investigative skills with the ability to connect the dots between technical data and operational processes.
• Conflict Resolution: Proven experience in handling difficult clients and managing high-pressure situations with a professional and calm demeanor.
• Communication: Excellent verbal and written communication skills in English and Bahasa Indonesia.
• Technical Literacy: Proficient in understanding how digital platforms/apps work and comfortable analyzing data or workflows.
• Independence: Ability to work autonomously, take initiative, and "poke" internal teams to get answers when necessary.