Executive - Claim Analyst, Contact Centre

IA International Assistance; Selangor; On-site; MYR 45,000 - 78,000; Full time

Job summary

IA International Assistance is seeking a proactive medical claims assessor in Malaysia to evaluate claims, ensure policy compliance, and resolve issues promptly. The role combines clinical review with frontline call duties in a fast-paced, 24/7 environment.

The ideal candidate will hold a Diploma in Nursing or Allied Health sciences, possess medical terminology knowledge, and be fluent in English and Bahasa Malaysia.

Qualifications

• Diploma in Nursing or Allied Health sciences required.
• Knowledge of medical terminology and billing processes.
• Fluent in English and Bahasa Malaysia.

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.

Skills

Medical terminology

Computer literacy

Fluent English

Fluent Bahasa Malaysia

Education

Diploma in Nursing or Allied Health sciences

Medical degree preferred

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.

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.