Medical Claims Assessor: Adjudication & Analytics

MediExpress (Malaysia) Sdn Bhd; Subang Jaya; On-site; MYR 60,000 - 90,000; Full time

Job summary

MediExpress (Malaysia) Sdn Bhd. is seeking a Claim Assessor to review and adjudicate medical claims on-site in Subang Jaya. The role requires strong claims management, analytical and communication skills to ensure accurate adjudication and compliance with policy terms.

The ideal candidate will verify documentation, assess eligibility, and coordinate with providers and insurers, contributing to fraud detection and cost efficiency. Immediate start for a dedicated professional.

Qualifications

• Experience assessing medical or insurance claims.
• Strong analytical skills to interpret medical documentation and data trends.
• Effective communication with members, providers, insurers, and internal teams.

Responsibilities

• Review, validate, and assess medical claims per policy terms and guidelines.
• Verify supporting documentation, eligibility and coverage, and adjudicate within turnaround times.
• Communicate with healthcare providers, insurers, corporate clients, and members to clarify claim information and resolve discrepancies.
• Identify claim trends and contribute to process improvements to enhance service quality and cost efficiency.

Skills

Claims management

Analytical skills

Communication skills

Insurance claims knowledge

Attention to detail

multitasking in fast-paced env

Education

Diploma or degree in Insurance, Healthcare Management, Business

Tools

Office software

Claims processing systems

Job description

MediExpress (Malaysia) Sdn Bhd. is seeking a Claim Assessor to review and adjudicate medical claims on-site in Subang Jaya. The role requires strong claims management, analytical and communication skills to ensure accurate adjudication and compliance with policy terms.

The ideal candidate will verify documentation, assess eligibility, and coordinate with providers and insurers, contributing to fraud detection and cost efficiency. Immediate start for a dedicated professional.