Executive, Claims Adjudicator (24/7 Cashless Administration)

Allianz Malaysia; Kuala Lumpur; On-site; MYR 56,000 - 78,000; Full time

Job summary

Allianz Malaysia invites applications for a role to process and review health claims, ensuring payments are made within turnaround time and policy guidelines. The position requires handling 24/7 operations for hospital admission and discharge while maintaining accuracy and patient-centric service.

The ideal candidate holds a health-related diploma or degree, 2–3 years in healthcare claims, strong English and Bahasa Malaysia, and is comfortable using AI tools such as ChatGPT or Copilot to boost

Qualifications

• Diploma or degree in medical/health sciences.
• 2–3 years in healthcare/medical claims.
• Good communication and bilingual English/Bahasa Malaysia.

Responsibilities

• Process and review health/medical claims for reimbursement within policy guidelines.
• Manage day-to-day 24/7 operations for guarantee facilities (hospital admission/discharge).
• Ensure claim settlements and payments within turnaround time and service standards.
• Support Helpline with medical reimbursement inquiries.
• Utilize AI tools like ChatGPT or Copilot to automate routine tasks.

Skills

Communication

English proficiency

Bahasa Malaysia

Education

Diploma/degree in health sciences

Tools

ChatGPT

Copilot

Job description

Does customer satisfaction inspire you? This role is to process and review all medical/ health claims within specified authority limit and ensure that payments are made within the turnaround time (TAT)

Does customer satisfaction inspire you? This role is to process and review all medical/ health claims within specified authority limit and ensure that payments are made within the turnaround time (TAT)

You'll Be Responsible For

• To assess and process all health/ medical claim for reimbursement in line with policy guidelines within authority limit
• Responsible for the day-to-day 24/7 operations for guarantee facilities (hospital admission and discharge)
• To be responsible for claim settlement and ensure payments are process within the agreed turnaround time and service standard
• To support Helpline team with enquiries pertaining to medical reimbursement
• Familiarity with using ChatGPT for automating routine tasks and enhancing productivity

Important To Your Success

• Diploma/ Degree in any medical or health science related field of study
• Minimum 2 - 3 years' working experience in healthcare related industry; knowledge in medical/ health claims
• Possess good communication skill and good command of spoken and written English and Bahasa Malaysia
• Meticulous and attention to details
• Able to work independently in a 24/7 fast-paced environment
• Result-oriented with sense of urgency towards True Customer Centricity
• Demonstrates ability to work as a team to deliver Allianz's enhanced customer experience journey
• Proficient in the use of AI tools such as ChatGPT, Copilot, or similar technologies to enhance productivity and work quality.
• Applicants must be willing to work in KL Sentral

Allianz Group is one of the most trusted insurance and asset management companies in the world. Caring for our employees, their ambitions, dreams and challenges, is what makes us a unique employer. Together we can build an environment where everyone feels empowered and has the confidence to explore, to grow and to shape a better future for our customers and the world around us.

At Allianz, we stand for unity: we believe that a united world is a more prosperous world, and we are dedicated to consistently advocating for equal opportunities for all. And the foundation for this is our inclusive workplace, where people and performance both matter, and nurtures a culture grounded in integrity, fairness, inclusion and trust.

We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, social class, disability or sexual orientation, or any other characteristics protected under applicable local laws and regulations.

Great to have you on board. Let's care for tomorrow.