Claims Quality & Operations Specialist

Prudential Group; Kuala Lumpur; On-site; MYR 20,000 - 100,000; Full time

Job summary

A leading insurance company in Kuala Lumpur is seeking a Claims Analyst to manage claim submissions and ensure compliance. Responsibilities include verifying claims, maintaining documentation, liaising with stakeholders, and mentoring junior staff. The ideal candidate should have a strong attention to detail and be committed to providing excellent service. This role also involves contributing to improved claims processes and assisting management with ad hoc tasks. Join us to grow your career in a supportive environment.

Responsibilities

• Examine claim submissions including inpatient and outpatient claims to ensure documentation accuracy.
• Verify the authenticity of claims by cross‑checking information.
• Liaise with claimants and medical professionals to gather necessary information.
• Maintain detailed records of claims assessments and decisions.
• Assist the Claims Manager in preparing reports.
• Ensure claims are processed in accordance with company policies.
• Provide customer service to stakeholders, addressing inquiries promptly.
• Mentor and support junior staff, providing guidance and training.
• Contribute to the development of improved claims assessment processes.
• Handle ad hoc assignments from management.

Job description

A leading insurance company in Kuala Lumpur is seeking a Claims Analyst to manage claim submissions and ensure compliance. Responsibilities include verifying claims, maintaining documentation, liaising with stakeholders, and mentoring junior staff. The ideal candidate should have a strong attention to detail and be committed to providing excellent service. This role also involves contributing to improved claims processes and assisting management with ad hoc tasks. Join us to grow your career in a supportive environment.