Associate, Care Services

Great Eastern Life; Kuala Lumpur; On-site; MYR 45,000 - 70,000; Full time

Job summary

A leading company in insurance solutions is looking for an Associate in Care Services. The role involves processing guarantee letter cases for policyholders, supporting medical inquiries, and handling fee disputes. Candidates should have a degree in Nursing or a related field with extensive experience in hospital and managed care environments.

Qualifications

• 5 years of experience in post-basic and management.
• 8 years in hospital environment, managed care, and medical insurance.
• Knowledge in medical terminology, MMA coding, and policy interpretation.

Responsibilities

• Adjudicate and process guarantee letter cases for medical policyholders.
• Support Call Centre Officers with technical/medical issues.
• Handle cases of fee disputes.

Skills

Analytical skills

Communication skills

Interpersonal skills

Problem-solving skills

Initiative

Education

Degree in Nursing or Healthcare-related discipline

Job description

Job Description - Associate, Care Services (250000UQ)

Job Number:

250000UQ

About the Job

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

• 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 and resolve cases of fee disputes.
• To assist the Care Manager in handling cases where medical necessity is questionable and decide on the course of action in consultation with medical officers.
• To attend to any other tasks assigned from time to time.

We are looking for people who:

• Have a Degree in Nursing or Healthcare-related discipline, such as State Registered Nurse or Medical Assistant, with 5 years of experience in post-basic and management. Experience in a public/private hospital is essential.
• Have not less than 8 years of working experience in hospital environment, managed care, and medical insurance.
• Possess knowledge in medical terminology, contract provisions, MMA coding, and policy interpretation and application.
• Have knowledge of current healthcare delivery systems, hospital patient management, and billing systems.
• Demonstrate good initiative, interpersonal, and communication skills.
• Have analytical and problem-solving skills.

How you succeed

• Champion and embody our core values in everyday tasks and interactions.
• Demonstrate a high level of integrity and accountability.
• Take initiative to drive improvements and embrace change.
• Take accountability for business and regulatory compliance risks, implementing measures to mitigate them effectively.
• Keep abreast of industry trends, regulatory compliance, emerging threats, and technologies to proactively identify potential concerns and risks.

Who we are

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 through three distribution channels: 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 maintained a financial strength and counterparty credit rating of "AA-" by S&P Global Ratings since 2010, among the highest in Asian life insurance companies. Great Eastern's asset management subsidiary, Lion Global Investors Limited, is a leading asset management firm in Southeast Asia. Great Eastern is a subsidiary of OCBC, Singapore’s oldest bank, established in 1932. OCBC is the second-largest financial services group in Southeast Asia by assets and holds an Aa1 rating from Moody’s and AA- from Fitch and S&P. Recognized for its financial strength and stability, OCBC is 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.

To All Recruitment Agencies: Great Eastern does not accept unsolicited agency resumes. Please do not forward resumes to our email or employees. We are not responsible for any fees related to unsolicited resumes.