Responsibilities:

Conduct daily concurrent reviews and audits of patient treatment files to ensure alignment with company strategies and regulatory compliance.
Ensure customers receive appropriate, effective treatments while avoiding unnecessary procedures or extended hospital stays.
Monitor customer and provider network behavior, escalating concerns to relevant stakeholders as needed.
Perform additional tasks and responsibilities as assigned.

Qualification:

Bachelor's degree in Nursing or a related field.
Minimum 2-3 years of experience in hospital nursing, preferably in ward or ICU settings.
At least 1 year of experience in life or non-life insurance and health claims (preferred).
Proven training and competency in negotiation, quality assurance, and case management outcomes.
Strong communication skills in Thai and English, both written and spoken (preferred)