Manager, Medical & Network Management

Hong Leong Assurance Berhad; Petaling Jaya; On-site; MYR 90,000 - 150,000; Full time

Job summary

Hong Leong Assurance Berhad (HLA) is seeking a seasoned professional to verify and approve staff payment vouchers, monitor medical payments against standard reimbursement rates, and coordinate with panel hospitals. You will handle inquiries, audits, and empanelment projects while supporting the claims team with evidence and data.

The role requires a degree in Healthcare Administration or related field, minimum 5 years in the industry, and strong data analysis with experience in claims systems.

Qualifications

• Degree in Healthcare Administration, Business, Insurance, or a related field.
• 5+ years of experience in related industry.
• Proficiency in data analysis and experience with claims/payment processing systems.
• Strong negotiation skills and ability to communicate with medical professionals and internal stakeholders.

Responsibilities

• Verify and approve payment vouchers processed by staff up to the reimbursement limit.
• Monitor medical payments to ensure they align with standard rates and benchmarks.
• Handle inquiries, complaints, or issues related to medical payments and panel hospitals.
• Review New Business panel clinic applications, renewals, and audits.
• Empanel and manage panel and preferred panel hospitals; support claims department with clear evidence.

Skills

Data analysis

Negotiation

Communication

Stakeholder management

Education

Degree in Healthcare Administration

Tools

Claims processing system

Medical panel systems

Job description

Verify and approve payment voucher processed by staffs up to the Individual conferred reimbursement limit. Also, to monitor and ensure medical payment is processed within the standard reimbursement rate and agreed service benchmarks.

Handle of enquiry, complaint or issue related to medical payment, New Business panel medical examiners & laboratories and Claims panel hospitals.

Handle panel medical examiner related project.

Review New Business panel clinic application, renewal and audit.

Handle empaneling of Claims panel hospitals and preferred panel hospitals.

Provide support to Claims department on enquiry or issue related to claims cases that required further clarification or supporting evidence from panel hospitals.

Identify issue, report and raise system request, as well as monitor its progression shall there be any issue arises or enhancement needed.

Collaborate with System Support Team for medical related data extraction and generate basic report following data analysis.

Planning and executing projects in accordance with the timeline, and delivering objectives.

Job Requirements:

Degree in Healthcare Administration, Business, Insurance, or a related field.

At least 5 years of experience in related industry.

Proficiency in data analysis and experience working with claims/payment processing systems.

Strong negotiation skills, a solution-oriented mindset, and the ability to communicate effectively with medical professionals and internal stakeholders.

Hong Leong Assurance Berhad (HLA) is one of the largest insurance companies in Malaysia. It is a well-established and respected Malaysian brand offering financial planning and protection solutions to meet the various needs of Malaysians at different cycles of their lives. Commitment to the customer is the key to HLA's success, where service is provided through a large network of branches, agents and brokers throughout the country as well as bancassurance and alternative distribution channels.

HLA began as a General Insurance business under the name of Malaysia Pacific Insurance Berhad in 1972. The Life Insurance business was added into its portfolio a year later. In December 1982, Hong Leong Assurance Sdn Bhd, a composite insurance company was formed eventually acquiring the entire General and Life business of Malaysia Pacific Insurance. Today, HLA is a subsidiary of HLA Holdings Sdn Bhd (HLAH), which is wholly-owned by Hong Leong Financial Group Berhad (HLFG), the financial services arm of Hong Leong Group Malaysia.

Pursuant to a strategic partnership, in October 2010, HLA merged its General Insurance business with MSIG Insurance (Malaysia) Bhd (MSIM). Concurrently, HLAH took a 30 percent equity interest in MSIM and Mitsui Sumitomo Insurance Company Limited (MSI) took a 30 percent equity interest in HLA. Moving forward, the General Insurance business would be provided by MSIM, while the life insurance business would continue to be provided by HLA.

With the strategic partnership, HLA is poised to reach new horizons for its Life Insurance business. HLA is today one of Malaysia's leading domestic brands for financial planning and protection solutions, specializing in Life Insurance products and services.

HONG LEONG FINANCIAL GROUP

Hong Leong Financial Group is a leading provider of financial services through the subsidiaries and associate companies of Hong Leong Financial Group Berhad.

The Group's Financial Services companies provide a broad spectrum of financial services - banking, treasury, insurance, fund management, investment banking, capital markets and stock-broking throughout Malaysia, Singapore, China, Hong Kong and Vietnam. Based in Kuala Lumpur, our products and services are distributed via a diverse range of distribution channels.

Our vision is to be an integrated services group that consistently meet our customers' financial and investment needs. Our goal is to become a leader in the financial services industry, a leader in each of the market that we operate in.

HONG LEONG GROUP MALAYSIA

Hong Leong Group is a leading conglomerate based in Malaysia with diversified businesses in manufacturing and distribution, financial services, property development & investment, and hospitality & leisure. The Group today controls 13 listed companies in various stock exchanges with over 500 operating subsidiaries and associate companies around the world. Now forty years in operation, the Hong Leong Group has successfully entrenched its brands deeply in the communities where it has a presence - in its home base Malaysia to the rest of Asia, in Western Europe and the UK, in North America and in Oceania.

HONG LEONG ASSURANCE BERHAD

Hong Leong Assurance Berhad (HLA) is one of the largest insurance companies in Malaysia. It is a well-established and respected Malaysian brand offering financial planning and protection solutions to meet the various needs of Malaysians at different cycles of their lives. Commitment to the customer is the key to HLA's success, where service is provided through a large network of branches, agents and brokers throughout the country as well as bancassurance and alternative distribution channels.

HLA began as a General Insurance business under the name of Malaysia Pacific Insurance Berhad in 1972. The Life Insurance business was added into its portfolio a year later. In December 1982, Hong Leong Assurance Sdn Bhd, a composite insurance company was formed eventually acquiring the entire General and Life business of Malaysia Pacific Insurance. Today, HLA is a subsidiary of HLA Holdings Sdn Bhd (HLAH), which is wholly-owned by Hong Leong Financial Group Berhad (HLFG), the financial services arm of Hong Leong Group Malaysia.

Pursuant to a strategic partnership, in October 2010, HLA merged its General Insurance business with MSIG Insurance (Malaysia) Bhd (MSIM). Concurrently, HLAH took a 30 percent equity interest in MSIM and Mitsui Sumitomo Insurance Company Limited (MSI) took a 30 percent equity interest in HLA. Moving forward, the General Insurance business would be provided by MSIM, while the life insurance business would continue to be provided by HLA.

With the strategic partnership, HLA is poised to reach new horizons for its Life Insurance business. HLA is today one of Malaysia's leading domestic brands for financial planning and protection solutions, specializing in Life Insurance products and services.

HONG LEONG FINANCIAL GROUP

Hong Leong Financial Group is a leading provider of financial services through the subsidiaries and associate companies of Hong Leong Financial Group Berhad.

The Group's Financial Services companies provide a broad spectrum of financial services - banking, treasury, insurance, fund management, investment banking, capital markets and stock-broking throughout Malaysia, Singapore, China, Hong Kong and Vietnam. Based in Kuala Lumpur, our products and services are distributed via a diverse range of distribution channels.

Our vision is to be an integrated services group that consistently meet our customers' financial and investment needs. Our goal is to become a leader in the financial services industry, a leader in each of the market that we operate in.

HONG LEONG GROUP MALAYSIA

Hong Leong Group is a leading conglomerate based in Malaysia with diversified businesses in manufacturing and distribution, financial services, property development & investment, and hospitality & leisure. The Group today controls 13 listed companies in various stock exchanges with over 500 operating subsidiaries and associate companies around the world. Now forty years in operation, the Hong Leong Group has successfully entrenched its brands deeply in the communities where it has a presence - in its home base Malaysia to the rest of Asia, in Western Europe and the UK, in North America and in Oceania.