Executive, Claims Adjudicator (24/7 Cashless Administration)

Allianz Malaysia; Kuala Lumpur; On-site; MYR 100,000 - 150,000; Full time

Job summary

A leading insurance and asset management company is seeking a dedicated Medical Claims Processor in Kuala Lumpur. Responsibilities include reviewing and processing claims for reimbursement while managing operations efficiently. The ideal candidate should have a relevant diploma or degree and experience in the healthcare sector, with a strong focus on customer satisfaction.

Benefits

Support for personal well-being

Career development opportunities

Qualifications

• 2-3 years' experience in healthcare industry with knowledge of medical claims.
• Proficient in English and Bahasa Malaysia.
• Ability to work independently in a 24/7 environment.

Responsibilities

• Assess and process health/medical claims for reimbursement.
• Manage day-to-day operations for guarantee facilities.
• Ensure timely processing of claim settlements.

Skills

Communication

Attention to Detail

Team Collaboration

Customer Centricity

Education

Diploma or Degree in Medical/Health Science field

Job description

Does customer satisfaction inspire you?

This role involves processing and reviewing all medical/health claims within specified authority limits to ensure payments are made within the designated turnaround time (TAT).

Responsibilities:

• Assess and process health/medical claims for reimbursement according to policy guidelines within authority limits.
• Manage day-to-day 24/7 operations for guarantee facilities, including hospital admissions and discharges.
• Ensure claim settlements and payments are processed within the agreed turnaround time and service standards.
• Support the Helpline team with inquiries related to medical reimbursement.
• Familiarity with using ChatGPT for automating routine tasks and enhancing productivity.

Qualifications for Success:

• Diploma or Degree in a medical or health science-related field.
• Minimum of 2-3 years' experience in the healthcare industry, with knowledge of medical/health claims.
• Good communication skills and proficiency in spoken and written English and Bahasa Malaysia.
• Meticulous with attention to detail.
• Ability to work independently in a fast-paced 24/7 environment.
• Result-oriented with a sense of urgency and a focus on customer centricity.
• Ability to work collaboratively as part of a team to enhance customer experience.
• Willing to work in KL Sentral.

What We Offer:

• Support for your personal well-being, family, community, and growth.
• Opportunities for career development within a rapidly growing organization.

Join Us and Grow Your Career

Thank you for your interest. Due to high application volume, we cannot provide individual feedback. If you do not hear from us within 14 days, please assume you have not been selected. All updates will be communicated via email. Please check your email regularly.

About Allianz: We are a trusted global insurance and asset management company committed to caring for our employees and fostering a diverse and inclusive workplace. We welcome applications from all backgrounds and identities.

We look forward to welcoming you onboard. Let's care for tomorrow.