Claims Excellence - Team Lead

Cognizant; Kuala Lumpur; On-site; MYR 80,000 - 120,000; Full time

Job summary

A global technology company in Kuala Lumpur is seeking a Supervisor for the Claims Excellence Team. This role is pivotal in overseeing post-payment claim reviews and delivering training programs to enhance the offshore team's performance. Candidates should have at least 5 years of medical claims processing experience, with 1 year in a supervisory role. Key skills include fluency in Cantonese, strong communication abilities, and a customer-oriented approach. This dynamic position requires effective collaboration with international teams to meet service excellence standards.

Qualifications

• 5 years of experience in medical claims processing, with 1-year supervisory experience.
• Experience in Claims Quality Assurance is preferred.
• Customer-oriented with excellent communication and interpersonal skills.
• Strong team player, willing to learn, able to work independently and under pressure.
• Self-motivated, analytical, and detailed-minded.

Responsibilities

• Assist in training and management of the offshore team.
• Provide ongoing training to Offshore Claims Team.
• Review quality assurance checking to ensure claim guidelines are followed.
• Collaborate with Bupa HK Claims Excellence team.
• Organize core training events and team-building activities.

Skills

Cantonese language speaking and reading fluently

Medical/Health Insurance domain

Claims operations

Excellent communication and interpersonal skills

Team player

Problem-solving ability

Job description

Mandatory Skill

• Cantonese language speaking and reading fluently
• Medical/Health Insurance domain
• Claims operations

Job Description

The Supervisor supports the Quality Assurance & Training Assistant Manager in overseeing the Claims Excellence Team. This role is responsible for ensuring that post‑payment claim reviews are completed within the established Service Level Agreements (SLAs). The Supervisor also assists in delivering training programs to the offshore team.

This position requires advanced knowledge of medical claims processes and the ability to identify potential risks or quality issues. The Supervisor is expected to recommend and implement corrective training measures to prevent recurrence of identified errors.

1. Assist the Assistant Manager/Manager in training and management of the offshore team to ensure operational efficiencies and effectiveness
2. Provide ongoing training to Offshore Claims Team and ensure that claim guidelines (as set by Bupa HK) are followed and executed efficiently
3. Review of offshore team's quality assurance checking to ensure that claim guidelines and practices provided by Bupa HK are delivered effectively and upgrading the service quality of the offshore Claims Team (including technical knowledge and servicing skills)
4. Working collaboratively with Bupa HK Claims Excellence team to ensure that SLA error rates are within the benchmark as set by Bupa HK and report any breaches immediately to Claim Excellence Bupa HK team for handling
5. Organizing various kinds of core training events and team / culture building activities

Desired Professional Experience

With 5 years of experience in medical claims processing (both inpatient and outpatient) with 1-year supervisory experience

Experience in Claims Quality Assurance is preferred

Customer‑oriented with excellent communication and interpersonal skills

Strong team player, willing to learn, able to work independently and under pressure

Self‑motivated, analytical and detailed‑minded in problem solving

Good sense of responsibility with high level of integrity and trust