CLAIMS EXECUTIVE OR ASSISTANT / CALL CENTRE EXECUTIVE

Compumed Services; Kuala Lumpur; On-site; MYR 28,000 - 47,000; Full time

Job summary

CompuMed in Kuala Lumpur is seeking a Claims Executive/Assistant to deliver quality customer service on medical/insurance claims and related clinical services. You will prepare submission documents, liaise with hospitals, and support the claims team in daily operations.

The role requires experience in healthcare/insurance claims, knowledge of policies, and strong Bahasa Malaysia & English communication skills. Training and career growth opportunities are offered.

Qualifications

• STPM/ A Level/ Pre-U/ Diploma/ Degree or equivalent.
• Experience in medical/insurance claims, hospital services or clinical services.
• Knowledge of insurance/medical terminologies and policies.
• Proficient in Bahasa Malaysia & English communication.

Responsibilities

• Deliver quality customer service and solutions for claims issues.
• Prepare documents for submission to insurers.
• Liaise with hospital staff on member management.
• Adjudicate claims for admission and outpatient cases.
• Ensure timely submission and monitor settlement timelines.
• Assist Call Centre & Claims team and mentor new hires.

Skills

Customer service

Communication

Insurance claims

Education

STPM / A Level

Diploma / Degree

Job description

Jora Malaysia will close on 9th September 2026. Thank you for being with us, we are cheering you on as you continue your career journey.

CLAIMS EXECUTIVE OR ASSISTANT / CALL CENTRE EXECUTIVE

JOB SCOPE (Major Responsibilities of this job)

• Deliver quality customer service and appropriate solutions with regards to medical/insurance claims and clinical services issues.
• Provide a polite, professional and accurate response in accordance with the agreed service standards.
• Liaise with hospital personnel with regards to the management of a member during pre-hospitalization, hospitalization and post hospitalization.
• Prepare complete documents for submission of claims to the insurance company.
• Update the status of members during hospitalization.
• Attend to inquiries from insurance companies and service providers with regards the Company’s operating procedures.
• Attend to inquiries and liaise with members regarding reimbursement procedures.
• Assist the Call Centre & Claims team and support to the new recruits in the Company.
• Subject to the shifts and abiding to the duty roster prepared by the Management.
• Approval of simple claims during and after office hours.
• Prepare Payment Notice, GL & DL, Admission, Billing in daily course of duties.
• To adjudicate claims for admission, outpatient and major claims.
• Compile supporting documents as attachment (including police report for MVA and assault claims) with each claim submission to relevant clients
• Prepare claims borderaux for submission to client/ Finance Department together with the complied supporting documents
• Ensure timely submission of claims and monitor closely on claims settlement timeline.
• Prepare performance report & productivity report as required
• Attend to inquiries with regards to claims operating procedures at CompuMed
• Deliver quality customer service and appropriate solutions with regards to medical/insurance claims and clinical services issues.
• Provide a polite, professional and accurate response in accordance with the agreed service standards.
• Liaise with hospital personnel with regards to the management of a member during pre-hospitalization, hospitalization and post hospitalization.
• Prepare complete documents for submission of claims to the insurance company.
• Update the status of members during hospitalization.
• Attend to inquiries from insurance companies and service providers with regards the Company’s operating procedures.
• Attend to inquiries and liaise with members regarding reimbursement procedures.
• Perform relief task as and when required by the Management.
• Maintain a proper filing system.

JOB SPECIFICATION

• At least STPM/ "A" Level/ Pre-U /Diploma/Degree or equivalent in any field.
• Those with medical/life insurance claims, hospital services, and clinical services experience
• Knowledge of insurance/medical terminologies and insurance policy.
• Working experience in healthcare, insurance or similar capacity.
• High level of work commitment and strong sense of responsibility
• Good understanding of medical insurance policies and it application is an added advantage
• Good spoken and written communication skills in Bahasa Malaysia & English
• Those with medical/life insurance claims, hospital services, and clinical services experience
• Knowledge of insurance/medical terminologies and insurance policy.
• Communication and interpersonal skills.
• Computer Literate
• Working experience in TPA, insurance or healthcare industry