Claims Executive / Senior Executive

Alliance Medinet (M) Sdn Bhd; Petaling Jaya; On-site; MYR 50,000 - 84,000; Full time

Job summary

Alliance Medinet (M) Sdn Bhd is seeking a proactive Claims Executive to join our corporate managed healthcare team in Malaysia. You will adjudicate medical claims accurately, validate to meet SLA targets, and review current processes to improve efficiency and claims experience.

You will manage escalations and stakeholder relations, champion change, and provide ongoing training for effective claims management.

Qualifications

• Strong technical understanding of the claims process for medical claims.
• Experience in a healthcare insurer/provider environment is advantageous.
• Excellent organisational skills and attention to detail.
• Excellent interpersonal and communication skills.

Responsibilities

• Provide accurate adjudication of medical claims and validate to meet SLA targets.
• Review claims processes and work with internal stakeholders to improve efficiency.
• Manage escalations and stakeholder relations.
• Champion change and provide ongoing training for effective claims management.
• Liaise with Insurance Companies to verify exceptions and resolve complaints.
• Conduct analysis and prepare periodic reports as required.

Skills

Claims adjudication

Stakeholder management

Communication skills

Independent work

Change champion

Job description

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, validation to meet operational and SLA targets

Conduct regular review of current claims 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 Company 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

Prior experience with a healthcare insurer provider is an advantage

Highly developed interpersonal skills

Excellent organisational skills and exceptional eye for details

Passionate about driving change to improve business outcomes.

Work independently with little guidance

Exceptional communication skills and stakeholder management skills

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

Your application will include the following questions:

• How many years' experience do you have as a Claims Executive?
• How many years' experience do you have as a Claims Specialist?
• Which of the following types of qualifications do you have?
• What's your expected monthly basic salary?
• Have you worked in a role which requires a sound understanding of claims management processes?
• How many years' experience do you have in the insurance industry?
• Which of the following statements best describes your right to work in Malaysia?
• Which of the following languages are you fluent in?

Alliance is a future-oriented healthcare brand. Since our founding in 1994, we have moved beyond the traditional healthcare model, harnessing technology to provide a comprehensive suite of services. We believe everyone is entitled to a healthy life and you deserve a personalised, safe, and dignified health journey. As we understand the importance of shifting care delivery from institutions to community, our healthcare solutions prioritise accessibility, efficiency, and personalisation.

Alliance is a future-oriented healthcare brand. Since our founding in 1994, we have moved beyond the traditional healthcare model, harnessing technology to provide a comprehensive suite of services. We believe everyone is entitled to a healthy life and you deserve a personalised, safe, and dignified health journey. As we understand the importance of shifting care delivery from institutions to community, our healthcare solutions prioritise accessibility, efficiency, and personalisation.