Process Executive - Claims Operations (Cantonese Speaker)

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

Job summary

A leading technology and services company in Kuala Lumpur seeks a Medical Claim Advisor to manage and assess medical insurance claims. Responsibilities include ensuring accuracy and compliance, verifying medical codes, and communicating effectively. Ideal candidates will have a background in healthcare and fluency in Cantonese, Mandarin, and English. This position offers opportunities for growth within a dynamic team environment.

Qualifications

• 0-2 years of experience in medical claims handling.
• Healthcare background preferred.
• Knowledge of billing codes (ICD 9, ICD 10, CPT) is preferred.
• Strong team player, willing to learn and work under pressure.

Responsibilities

• Assess medical claims for compliance with policy terms.
• Verify medical codes and diagnoses.
• Escalate complex cases to senior staff.
• Process claims payments according to guidelines.

Skills

Medical claims handling

Knowledge of medical terminology

Fluency in Cantonese

Fluency in Mandarin

Fluency in English

Team player

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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