Individual Benefit Cashless Claim, Analyst

AIA Hong Kong and Macau; Kuala Lumpur; On-site; MYR 60,000 - 90,000; Full time

Job summary

A leading health insurance provider in Kuala Lumpur is seeking a Health Insurance Claims Officer. In this role, you will lead a team handling claims assessment and ensure compliance with company guidelines. You'll need a Bachelor's degree in a medical field and at least 2 years of relevant experience. Candidates should be proficient in English and Bahasa Malaysia. Join us in our mission to help customers live Healthier, Longer, Better Lives.

Qualifications

• Minimum 2 years of experience in health insurance or related field.
• Proficient in English and Bahasa Malaysia.
• Proficient in English and Bahasa Malaysia.

Responsibilities

• Lead and support a team in health insurance claims processing.
• Ensure compliance with company requirements and guidelines.
• Conduct quality audits for team performance.
• Assist in staffing and workload management to meet shift targets and GL process needs.
• Ensure timely issuance of guarantee letters within targeted TAT and provide coaching as needed.

Skills

Claims assessment

Medical report knowledge

Health Insurance Policy knowledge

Education

Bachelor's degree in medicine or medical fields

Job description

**At AIA we’ve started an exciting movement to create a healthier, more sustainable future for everyone.***It’s about finding new ways to not only better people's lives, but to better the communities and environments we live in. Encompassing our ambition of helping a billion people live Healthier, Longer, Better Lives by 2030.**And to get there, we need ambitious people who believe in playing an important part in shaping that future. People seeking unmatched career and personal growth opportunities, who are driven to work with, and learn from some of the most inspiring and supportive leaders in the business.***About the Role**Responsible for determining the validity and authorising settlement of individual health insurance claims**Roles & Responsibilities:*** To support and lead a team of assessors in pre-certification, hospitalization, case management in the issuance of guarantee letter in compliance to Company’s requirements and guidelines.* To ensure quality audits are done for the respective team members.* To pre-certify cases for issuance of guarantee letter in compliance to Company’s requirements and guidelines assist the team target productivity benchmark.* To ensure guarantee letters are issued accurately and correctly within targeted TAT and with authority assigned.* To assist in the assignment and monitoring of all documents received in their respective team’s queues.* To assist WFM team in ensuring sufficient headcount as scheduled on the shift rotation on a monthly basis to cater for the GL process.* To ensure huddles and communications are carried out as per the agreed frequency.* To ensure coaching and engagement activities are carried out for performance improvement and cost containment.* To ensure that cases of fee disputes are handled and resolved within targeted TAT.* To ensure that error rate in GL issuance is less that the target.* To perform other responsibilities and duties periodically assigned by supervisor in order to meet operational and/or other requirements.**Minimum Job Requirements:*** Education: Bachelor's degree in medicine or medical fields* Years of Experience: Minimum 2 years of experience* Technical Skills: Claims assessment, Medical report knowledge, Health Insurance Policy knowledge* Industry: Health Insurance, Third-Party Administrator, Hospitals, Clinics, Medical Labs* Language: English and Bahasa Malaysia*Build a career with us as we help our customers and the community live Healthier, Longer, Better Lives.**You must provide all requested information, including Personal Data, to be considered for this career opportunity. Failure to provide such information may influence the processing and outcome of your application. You are responsible for ensuring that the information you submit is accurate and up-to-date.*