Claims Executive

MSH SEA SDN BHD; Sentral; On-site; MYR 100,000 - 150,000; Full time

Job summary

A leading multinational health insurance firm in Kuala Lumpur is seeking a Claims Executive. Responsibilities include processing reimbursement claims, managing relationships with members and healthcare providers, and providing support. Ideal candidates will have a diploma or degree in relevant fields, strong communication skills, and proficiency in Microsoft Office. Additional language skills are an asset. Join us for a dynamic career in a multicultural environment.

Benefits

Dynamic multicultural work environment

Comprehensive training and mentorship

Support from experienced professionals

Qualifications

• Fluency in English; additional languages are a strong asset.
• Previous experience or internships in insurance or customer service.
• Keen attention to detail and accuracy in managing claims.

Responsibilities

• Process reimbursement claims in compliance with contracts.
• Manage relationships with members and healthcare providers.
• Provide support and information to insured members.

Skills

Exceptional communication skills

Attention to detail

Organizational skills

Customer service skills

Multitasking abilities

Education

Diploma or Bachelor's Degree in Medical Sciences, Languages, or Office Administration

Tools

Microsoft Office

Job description

About us

MSH International is a global leader in international health and life insurance solutions. With over 1,400 staff across 6 regional offices worldwide and 50 years of expertise, we are proud to offer tailored services to our members. As a multinational company, we are committed to nurturing young talents and providing excellent career growth opportunities.

Whether you have experience in medical claims or are a fresh graduate eager to learn, we invite you to join us!

Position – Claims Executive

Role & Responsibilities

Process reimbursement claims from members and hospital claims, ensuring alignment with client contracts and SLAs.

Manage relationships with insured members, healthcare providers, and stakeholders, supporting portfolio management and related activities.

Process reimbursement claims by:

• Verifying the insured member's coverage.
• Confirming up-to-date premium payments when necessary.
• Checking rates (Usual Customary Rates) and applicable discounts.
• Ensuring compliance with contractual terms.
• Updating databases with accurate claim information.
• Inputting payment statements into the system and resolving rejected payments.
• Providing payment summaries for senior review.
• Managing external data integration from third parties.
• Handle regularization requests, undue payments, returned payments, and specific cases.
• Provide support and information to insured members via telephone (level 2 and overflow), mail, and email.
• Manage and resolve complex cases in collaboration with the high claims team, medical team, and department managers.
• Follow up on client requests and complaints to ensure timely and effective resolution.

Qualifications & Experience

We are looking for candidates with the following profile:

Diploma or Bachelor’s Degree in Medical Sciences, Languages, or Office Administration.

Previous experience or internships in:

• Insurance industry, Third Party Administration, or Call Centers.
• Customer Service, administrative roles, or similar functions.

Proficiency in Microsoft Office, especially Excel, and familiarity with email and internet tools.

Language skills: Fluency in English is required. Proficiency in one or more additional languages (e.g., French, Spanish, Thai, Korean, Japanese) will be a strong asset and may command a higher salary.

Skills

Exceptional communication skills (both oral and written).

Keen attention to detail and ability to manage diverse insurance contracts accurately.

Strong organizational skills with a focus on prioritization and efficiency.

High levels of accuracy and assiduity in work.

Ability to multitask, adapt to changing situations, and work under pressure.

Strong customer service skills, including diplomacy, tact, and active listening.

Proficient planning and time management capabilities.

Knowledge of medical terminology is a plus.

Team player with a collaborative mindset.

What we offer

A dynamic and multicultural work environment.

Comprehensive training and mentorship for fresh graduates.

Support from experienced professionals to help you succeed in your role.

Apply now and grow your career with MSH International!

To learn more about us, visit: https://www.msh-intl.com/en/about-us.html

Your application will include the following questions:

• Which of the following statements best describes your right to work in Malaysia?
• What's your expected monthly basic salary?
• Which of the following types of qualifications do you have?
• How many years' experience do you have in the insurance industry?
• Which of the following languages are you fluent in?
• Which of the following Microsoft Office products are you experienced with?
• How would you rate your English language skills?
• How much notice are you required to give your current employer?