Manager, Medical Claims (Insurances & GL)

Sunway Medical Centre; Selangor; On-site; MYR 80,000 - 100,000; Full time

Job summary

A leading healthcare provider in Malaysia is seeking a Manager for Medical Claims to lead the development of effective management systems in the Business Office. Responsibilities include enhancing service recovery processes and ensuring efficient operations of the GL team. Candidates must possess a Degree in Medicine/Nursing and have at least 5 years of experience in the Healthcare industry. Excellent communication and multitasking skills are essential.

Qualifications

• Minimum 5 years of working experience required.
• Preferably candidates from the Medical/Healthcare industry.
• Ability to work in a fast-paced and result-oriented environment.

Responsibilities

• Lead the development of GL control systems in Business Office operations.
• Enhance service recovery processes for better risk management.
• Supervise GL team operations ensuring efficiency and professionalism.

Skills

Knowledge in medical terminology

Excellent verbal and written communication skills

Excellent organizational and multitasking abilities

Education

Degree in Bachelor of Medicine / Nursing

Job description

Manager, Medical Claims (Insurances & GL)

Lead and manage the development and implementation of effective and efficient management of Guarantee Letter (GL) control systems in Business Office operations to strengthen internal revenue management processes and the Company's bottom line.

Demonstrate efficiency in handling transactional activities and excellent customer service to serve the needs of customers.

Lead and develop business office capabilities to defuse the severity of service failures and enhance service recovery processes to support better financial and medical-legal risk management.

Ensure the daily activities governing the operation of the GL team are completed efficiently, courteously, and professionally.

Develop and implement functional and operational policies and procedures that govern business office admission, billing and discharge process under Daycare, following company-prescribed guidelines and accreditation standards.

Supervise and develop direct reports\' functional competencies to meet work output and quality, and adhere to company policies and operating standards.

Job Requirement

• MUST have Degree in Bachelor of Medicine / Nursing
• Knowledge in medical terminology is required
• Minimum 5 years of working experiences
• Working knowledge of the 13th Schedule & Procedure Code, billing, and registration
• Preferably candidates from Medical/Healthcare industry
• Knowledge of hospital information systems and management of multiple patient & customer segments and payment modes environment is preferred
• Able to work independently and in a team with the ability to thrive in a fast-paced and result-oriented environment
• Ability to work long hours, often under pressure
• Excellent verbal and written communication skills
• Excellent organizational and multitasking abilities

Company

Sunway Healthcare is part of the Sunway Group, one of Malaysia\'s largest conglomerates with core interest in property, construction, education and healthcare. The group currently runs Sunway Medical Centre, which is one of the largest private tertiary hospitals in the region with 636 beds and is accredited with the Australian Council on Healthcare Standards (ACHS). The group is also building 5 more hospitals in different cities in Malaysia which will complete in stages over the next four years.

To help fast track investigation, please note this job description is a refinement of the original posting and may be updated as needed.