Executive - Claim Analyst, Contact Centre

IA International Assistance; Petaling Jaya; On-site; MYR 40,000 - 65,000; Full time

Job summary

IA International Assistance in Malaysia seeks a Claims Assessment Specialist to evaluate and process medical insurance claims for accuracy, policy compliance, and timely resolution in a 24/7 environment.

You will audit billing, treatment necessity and diagnostic validity while handling front-line tasks such as phone support and risk mitigation on rotating shifts.

Attention to detail and strong communication in English and Bahasa Malaysia are essential for success.

Qualifications

• Diploma in Nursing or Allied Health sciences.
• Good command of English and Bahasa Malaysia.
• Experience in healthcare, insurance or call centres is a plus.
• Fresh graduates welcome.

Responsibilities

• Claims Assessment & Investigation: evaluate medical claims and billings against policy guidelines; investigate complex claims.
• Operational Performance: manage calls, meet TAT, maintain billing accuracy and KPIs.
• Shift Work: 24/7 rotational schedule (AM/PM/Night).

Skills

Medical terminology

English

Bahasa Malaysia

Fluent communication

Education

Diploma in Nursing

Allied Health sciences

Job description

Evaluates and processes medical insurance claims to ensure accuracy, policy compliance, and timely resolution. Operating in a 24/7 environment, the role balances medical review such as auditing billing reasonableness, treatment necessity, and diagnostic validity with operational front-line tasks, including phone support and risk mitigation.

Responsibilities

• Claims Assessment & Investigation: Evaluate medical claims, treatment plans, and billings against policy guidelines; investigate suspicious or complex claims before issuing payment guarantees.
• Operational Performance: Manage incoming and outgoing calls, meet turn-around times (TAT), maintain billing accuracy, and achieve operational KPIs.
• Shift Work: Operate on a 24/7 rotational schedule (AM, PM, Overnight) to maintain continuous service levels.

Qualifications

• Education: Minimum Diploma in Nursing or Allied Health sciences (Medical Degree preferred).
• Skills & Knowledge: Medical terminology (diseases/treatments), computer literacy, and fluency in English and Bahasa Malaysia.
• Experience: Background in Healthcare, TPA, Insurance, or Contact/Call Centres is advantageous (fresh graduates welcomed).
• Eligibility: Malaysian citizen or legal resident, comfortable with shift rotations and high-stress environments.