Claims Executive / Senior Executive

Alliance Medinet; Selangor; On-site; MYR 45,000 - 89,000; Full time

Job summary

Alliance Medinet Malaysia is seeking dynamic professionals to join our claims team within our corporate managed healthcare business. You will adjudicate medical claims accurately and efficiently, validating against SLA targets.

You will review current processes with internal stakeholders to streamline operations, manage escalations, and liaise with Insurance Companies to resolve exceptions. Fresh graduates are welcome to apply and grow with our team.

Qualifications

• Strong understanding of medical claims processes.
• Experience in a Third-Party Administrator or managed care environment preferred.
• Excellent interpersonal and organizational skills.
• Ability to work independently with minimal guidance.
• Excellent communication and stakeholder management.

Responsibilities

• Provide accurate adjudication and validation of medical claims.
• Review claims processes and propose improvements.
• Manage escalations and stakeholder relations.
• Deliver training and development for effective claims management.
• Liaise with Insurance Company to verify exceptions and resolve complaints.
• Prepare periodic analysis, reports and presentations when required.

Skills

Stakeholder management

Communication skills

Attention to detail

Change management

Independent work

Fresh graduates welcome

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, 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

Fresh graduates are highly encouraged to apply.

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