Health Claims Training & SOP Governance Analyst

AIA Hong Kong; Kuala Lumpur; On-site; MYR 60,000 - 75,000; Full time

Job summary

A leading insurance company in Kuala Lumpur is seeking an experienced professional for health claims management. You will conduct audits, manage policy cases, and implement process improvements. The ideal candidate has over 5 years of experience in health claims or clinical roles, with strong analytical and communication skills. Join us as we strive to improve lives and contribute to the community.

Qualifications

• 5+ years of experience in health claims management or clinical advisory roles.
• Experience in audit or quality assurance is preferred.
• Knowledge of insurance claims adjudication and MOH guidelines.

Responsibilities

• Conduct audits and manage complex policy cases to prevent fraud.
• Implement process improvements within insurance operations.
• Mentor and guide team members in decision-making.

Skills

Analytical skills

Audit skills

Communication

Stakeholder management

Proficiency in MS Office

Education

Bachelor’s degree in health sciences or equivalent

Tools

Claims platforms

Report automation tools

Job description

A leading insurance company in Kuala Lumpur is seeking an experienced professional for health claims management. You will conduct audits, manage policy cases, and implement process improvements. The ideal candidate has over 5 years of experience in health claims or clinical roles, with strong analytical and communication skills. Join us as we strive to improve lives and contribute to the community.