Process Executive - Claims Operations (Cantonese Speaker)

Cognizant; Kuala Lumpur; On-site; MYR 100,000 - 150,000; Full time

Job summary

A global technology company in Kuala Lumpur is seeking a Medical Claim Advisor to handle daily claim processing and evaluate medical insurance claims. The ideal candidate has up to 2 years of experience in medical claims, a healthcare background, and fluency in Cantonese, Mandarin, and English. Join a team to ensure accurate and timely claim resolutions.

Qualifications

• 0-2 years of experience in medical claims handling.
• A healthcare background is preferred.
• Strong team player, willing to learn, able to work independently and effectively under pressure.

Responsibilities

• Assess medical claims in compliance with policy terms and conditions.
• Verify medical codes and diagnosis to ensure compliance with industry standards.
• Process claims payment according to company guidelines.

Skills

Medical claims handling

Knowledge of medical terminology

Billing codes (ICD 9, ICD 10, CPT)

Fluent in Cantonese

Fluent in Mandarin

Fluent in English

Job description

Summary of the Role:

The Medical Claim Advisor is responsible for daily claim processing and evaluating medical insurance claims to ensure accuracy, compliance, and timely resolution. The role involves reviewing documentation, verifying coverage and communicating with their seniors to facilitate smooth claim processing.

Duties

• Assess medical claims in compliance with the terms and conditions of the policy
• Verify medical codes, diagnosis and procedure to ensure compliance with industry standards (e.g. ICD 9, ICD 10, CPT)
• Escalate enquiries and complex cases to Senior, when necessary, in line with internal guidelines
• Process claims payment in accordance with the company's objectives and guidelinesPrepare claim communication letter

Desired Professional Experience

• 0-2 years of experience in medical claims handling
• A healthcare background is preferred
• Knowledge of medical terminology, billing codes (ICD 9, ICD 10, CPT) and medical insurance policies is preferred
• Strong team player, willing to learn, able to work independently and effectively under pressure
• Fluent 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.

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