Assistant Manager, Care Services

Great Eastern; Kuala Lumpur; On-site; MYR 70,000 - 90,000; Full time

Job summary

A leading insurance provider in Kuala Lumpur is looking for an Assistant Manager, Care Services to process medical claims efficiently. Candidates should have a degree in Nursing or a healthcare-related field, with at least 8 years of experience in the healthcare sector, particularly in hospitals. Responsibilities include managing guarantee letter cases and supporting call center operations. The role promises a permanent position with opportunities for growth in a reputable organization.

Qualifications

• 5 years of experience in post-basic and management.
• Not less than 8 years of working experience in the hospital environment.
• Experience in a public/private hospital is essential.

Responsibilities

• Adjudicate, review, and process guarantee letter cases for medical policy holders.
• Issue initial and final guarantee letters accurately and timely.
• Support Call Centre Officers in handling technical/medical issues.

Skills

Medical terminology

Contract provisions

Teamwork

Accountability

Adaptability

Education

Degree in Nursing or Healthcare-related discipline

Job description

As a LIFE company, our customers are at the heart of all that we do. Being one of Asia’s leading insurer for over a century, we have built a long‑lasting legacy of trust with our customers over many generations. At the foundation of this trust is Integrity, Initiative, and Involvement – from the way we treat every customer relationship with honesty and transparency, to our proactive approach of delivering the best possible solutions in both life and general insurance.

Integrity, Initiative, and Involvement is what guides us. It is what makes us do the right thing, take the lead, and choose ‘we’ over ‘me’. Our mission is to make life great for our customers because we understand what matters most to them, and we know how to help them protect it.

If you are looking to grow in an exciting career filled with opportunities and potential, we are seeking an ideal candidate to join our team as an Assistant Manager, Care Services with our GELM Operations‑Medical Claims team.

Job Purpose

To adjudicate, review and process guarantee letter cases for medical policy holders.

The Job

• To issue initial and final guarantee letters in accordance with Company’s requirements and guidelines, accurately and timely.
• To support Call Centre Officers in handling technical/medical issues.
• To handle/resolve cases of fee dispute.
• To assist Care Manager in handling cases where medical necessity is questionable and decide on the course of action in consultation with medical consultant.
• To attend to any other tasks assigned from time to time.
• Takes accountability in considering business and regulatory compliance risks and takes appropriate steps to mitigate the risks.
• Maintains awareness of industry trends on regulatory compliance, emerging threats and technologies in order to understand the risk and better safeguard the company.
• Highlights any potential concerns /risks and proactively shares best risk management practices.

Our Requirements

• Degree in Nursing or Healthcare related discipline of State Registered Nurse or Medical Assistant with 5 years of experience in post‑basic and management.
• Experience in a public/private hospital is essential.
• Not less than 8 years of working experience in the hospital environment, managed care and medical insurance.
• Knowledge in medical terminology, contract provisions and MMA coding.
• Policy interpretation and application.
• Knowledge in current healthcare delivery systems, hospital patient management and billing system.
• High level of integrity, takes accountability of work and good attitude over teamwork.
• Takes initiative to improve current state of things and adaptable to embrace new changes.

Location: Great Eastern Malaysia, HQ

Entity: Great Eastern Life Malaysia

Employment Type: Permanent

About Great Eastern

Founded in 1908, Great Eastern is a well‑established market leader and trusted brand in Singapore and Malaysia. With over S$100 billion in assets and more than 16 million policyholders, including 12.5 million from government schemes, it provides insurance solutions to customers through three successful distribution channels – a tied agency force, bancassurance, and financial advisory firm Great Eastern Financial Advisers. The Group also operates in Indonesia and Brunei.

The Great Eastern Life Assurance Company Limited and Great Eastern General Insurance Limited have been assigned the financial strength and counterparty credit ratings of “AA‑” by S&P Global Ratings since 2010, one of the highest among Asian life insurance companies. Great Eastern's asset management subsidiary, Lion Global Investors Limited, is one of the leading asset management companies in Southeast Asia.

Great Eastern is a subsidiary of OCBC, the longest established Singapore bank, formed in 1932. It is the second largest financial services group in Southeast Asia by assets and one of the world’s most highly‑rated banks, with an Aa1 rating from Moody’s and AA‑ by both Fitch and S&P. Recognised for its financial strength and stability, OCBC is consistently ranked among the World’s Top 50 Safest Banks by Global Finance and has been named Best Managed Bank in Singapore by The Asian Banker.