Claims Executive / Senior Executive

Alliance Medinet; Johor Bahru; On-site; MYR 60,000 - 90,000; Full time

Benefits offered by this job

Job summary

Alliance Medinet is seeking dynamic professionals to join our claims team in our corporate managed healthcare business. The role focuses on adjudication of medical claims, processing logs, and driving process improvements to enhance efficiency and claims experience.

You will liaise with insurers/clients, manage escalations, and provide ongoing training to ensure effective claims management and stakeholder satisfaction.

Qualifications

• Strong technical understanding of medical claims processes.
• Excellent interpersonal skills and conflict resolution.
• Excellent organizational skills with keen attention to detail.
• Passionate about driving change to improve outcomes.
• Exceptional communication and stakeholder management abilities.

Responsibilities

• Provide accurate adjudication of medical claims and LOGs to meet targets.
• Review current claims processes and work with stakeholders on improvements.
• Manage escalations and maintain stakeholder relations.
• Deliver training and development for effective claims management.
• Liaise with insurers/clients to verify exceptions and resolve complaints.
• Analyze data and prepare periodic reports and presentations.

Skills

Claims adjudication

Stakeholder management

Communication

Change management

Process improvement

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.

We are seeking dynamic professionals to join our claims team in our corporate managed healthcare business.

The Job:

Provide accurate and efficient adjudication of claims/LOG, validation to meet operational and SLA targets

Conduct regular review of current claims/LOG processes and working with internal stakeholders on developing new and improved processes to improve efficiency and overall claims experience

Manage escalations and stakeholder relations

Being a champion for change as well as providing on-going training and development for effective claims management.

Liaise with the Insurance Companies/Clients to verify exceptions as well as to resolve any complaints

Conduct analysis, prepare periodic reports and presentation when required

Requirements:

Strong technical understanding of the claims process for medical claims, preferable in a Third-Party Administrator/Managed Healthcare environment

Highly developed interpersonal skills

Excellent organisational skills and exceptional eye for details

Passionate about driving change to improve business outcomes.

Exceptional communication skills and stakeholder management skills

To know more about our organisation, please visit https://www.alliancehealthcare.com.sg