Process Executive - Claims Excellence (Cantonese Speaker)

Cognizant; Kuala Lumpur; On-site; MYR 40,000 - 60,000; Full time

Job summary

A global technology company in Kuala Lumpur is looking for a Health Insurance Claims Specialist to process and validate insurance claims. The ideal candidate will have a bachelor's degree in a relevant field and be fluent in Cantonese, Mandarin, and English. This role involves ensuring compliance with insurance regulations, maintaining confidentiality, and effective communication with stakeholders.

Qualifications

• Bachelor’s degree in insurance, Business Administration, Healthcare Management, or related field.
• Basic understanding of health insurance products and claims lifecycle.
• Proficiency in Microsoft Office and claims management software.
• Strong attention to detail and organizational skills.
• Fluency in Cantonese, Mandarin, and English (speak, read, and write).

Responsibilities

• Assist in validating and processing health insurance claims.
• Ensure accurate data entry and documentation of claim details.
• Support the review of claims for completeness.
• Coordinate with internal departments for missing documentation.
• Maintain confidentiality and data protection standards.
• Respond to inquiries from policyholders regarding claims.
• Ensure timely processing of claims to meet SLAs.
• Participate in training related to claims systems.

Skills

Attention to detail

Organizational skills

Effective communication

Proficiency in Microsoft Office

Fluency in Cantonese

Fluency in Mandarin

Fluency in English

Education

Bachelor’s degree in insurance, Business Administration, Healthcare Management, or related field

Tools

Claims management software

Job description

Job Responsibilities and Expectations:

• Assist in validating and processing health insurance claims in accordance with Insurance Authority (IA) guidelines.
• Ensure accurate data entry and documentation of claim details in the claims management system.
• Support the review of claims for completeness and compliance with policy terms and conditions.
• Coordinate with internal departments to gather missing documentation or information.
• Flag potential discrepancies or anomalies for further review.
• Maintain confidentiality and data protection standards in handling sensitive health information.
• Respond to basic inquiries from policyholders regarding claim status and documentation requirements.
• Ensure timely processing of claims to meet service level agreements (SLAs).
• Assist in generating reports for internal tracking and audit purposes.
• Stay updated on changes in claims procedures and regulatory requirements in Hong Kong.
• Support continuous improvement initiatives in claims processing workflows.
• Participate in training sessions related to claims systems and regulatory updates.
• Service and resolve inquiries from customers, members, beneficiaries, and others regarding Health Care products and benefits across multiple product lines.
• Ability to communicate effectively across multiple channels, including phone, e-mail, chat, and text.
• Ability to succinctly collect information from a customer to set up a new claim.
• Ability to gather information from multiple source systems to understand and articulate the status of a claim – and what information may be needed, next steps in processing, etc.

Academic and Additional Qualifications Needed:

• Bachelor’s degree in insurance, Business Administration, Healthcare Management, or related field.
• Basic understanding of health insurance products and claims lifecycle.>
• Proficiency in Microsoft Office and claims management software.
• Strong attention to detail and organizational skills.
• Fluency in Cantonese, Mandarin, and English (speak, read, and write).

About Cognizant:

Cognizant (Nasdaq: CTSH) engineers’ modern businesses. We help our clients modernize technology, reimagine processes and transform experiences so they can stay ahead in our fast-changing world. Together, we're improving everyday life. See how at www.cognizant.com or @cognizant.