Senior Health Claims Operations Leader

Chubblifefund; Malaysia; On-site; MYR 40,000 - 60,000; Full time

Job summary

Chubblifefund in Malaysia is seeking a professional to manage claims operations, ensuring best practices in delivering services. Responsibilities include auditing claims, overseeing payment processing, and maintaining compliance with regulations.

The ideal candidate will have the ability to communicate effectively with management and stakeholders, along with monitoring claims trends and managing performance metrics effectively.

Responsibilities

• Assessment of Group and Individual hospitalisation and surgical claims – reimbursement basis.
• Auditing cashless claims for Group and Individual hospitalisation and surgical claims.
• Overseeing and facilitating payment processing for bordereaux medical claims.
• Performing sanctions checks on all relevant parties.
• Monitoring the performance of the appointed TPA.
• Keeping constant communication with management and underwriting teams.
• Providing feedback on any visible claims trends.
• Monthly/Quarterly/Yearly review of aging files.
• Participate in Ad Hoc projects or tasks as assigned.

Job description

Chubblifefund in Malaysia is seeking a professional to manage claims operations, ensuring best practices in delivering services. Responsibilities include auditing claims, overseeing payment processing, and maintaining compliance with regulations.

The ideal candidate will have the ability to communicate effectively with management and stakeholders, along with monitoring claims trends and managing performance metrics effectively.