Senior Manager, Individual Benefit Cashless Claim

AIA; Kuala Lumpur; On-site; MYR 180,000 - 320,000; Full time

Job summary

AIA Malaysia invites an experienced Operations Leader to head end-to-end Cashless Medical Claims and Guarantee Letter (GL) operations for Individual and Employee Benefits portfolios. You will ensure timely, accurate claim decisions, and drive service excellence, compliance and customer experience.

You will lead a team of managers, coach staff, monitor productivity and backlogs, collaborate with Contact Centre, Hospitals, and external partners, and deliver performance reports to stakeholders.

Qualifications

• Degree in Insurance, Healthcare, Business Administration or related field.
• Minimum 8 years of experience in medical claims, cashless operations or healthcare administration.
• Minimum 3 years of leadership experience managing operational teams.

Responsibilities

• Manage daily Cashless Medical Claims and GL operations for IB and Additional Guarantee requests for IB & EB portfolios.
• Ensure cases are assessed accurately and completed within established TATs and service standards.
• Monitor productivity, inventory, backlog, ageing cases and case clearance.
• Handle complex, urgent and escalated cases while ensuring appropriate resolution.
• Lead, coach and develop Team Leaders and staff to achieve operational and service objectives.
• Drive performance management, workforce planning and capability development.
• Manage key stakeholders including Contact Centre, Branches, Customer Service, Technology, Takaful, Underwriting, Claims, Medical Management and other business units.
• Collaborate with panel hospitals and healthcare providers to ensure smooth cashless admission services.
• Manage customer, agent, provider and management escalations, ensuring timely resolution.
• Ensure compliance with operational guidelines, governance requirements, policies and regulatory standards.
• Drive process improvements, automation initiatives and operational excellence projects.
• Prepare and present operational performance reports, service metrics and management updates.

Skills

Leadership

Stakeholder management

Healthcare operations

Process improvement

Team development

Education

Degree in Insurance/Healthcare/Business Admin

Tools

Med claims systems

Job description

Build a healthier and more sustainable future for everyone. At AIA, your skills, perspective and ideas can contribute to our Purpose of helping millions of people live Healthier, Longer, Better Lives. Across our diverse markets, you will take on meaningful challenges, collaborate with talented colleagues and help turn ideas into positive outcomes for our customers and communities. Join us to shape what comes next, grow through new experiences and extend your impact across Asia.

About the Role

Lead and manage the end-to-end Cashless Medical Claims and Guarantee Letter (GL) operations for Individual Business (IB), including Additional Guarantee requests for both IB and Employee Benefits (EB) portfolios. Support Health Operations Project managements Ensure timely, accurate and compliant claim decisions, strong stakeholder collaboration, operational efficiency, and excellent customer experience.

Roles and Responsibilities

• Manage daily Cashless Medical Claims and GL operations for IB and Additional Guarantee requests for IB & EB portfolios.
• Ensure cases are assessed accurately and completed within established TATs and service standards.
• Monitor productivity, inventory, backlog, ageing cases and case clearance.
• Handle complex, urgent and escalated cases while ensuring appropriate resolution.
• Lead, coach and develop Team Leaders and staff to achieve operational and service objectives.
• Drive performance management, workforce planning and capability development.
• Manage key stakeholders including Contact Centre, Branches, Customer Service, Technology, Takaful, Underwriting, Claims, Medical Management and other business units.
• Collaborate with panel hospitals and healthcare providers to ensure smooth cashless admission services.
• Manage customer, agent, provider and management escalations, ensuring timely resolution.
• Ensure compliance with operational guidelines, governance requirements, policies and regulatory standards.
• Drive process improvements, automation initiatives and operational excellence projects.
• Prepare and present operational performance reports, service metrics and management updates.

Minimum Job Requirements

• Degree in Insurance, Healthcare, Business Administration or related field.
• Minimum 8 years of experience in medical claims, cashless operations or healthcare administration.
• Minimum 3 years of leadership experience managing operational teams.
• Strong knowledge of medical claims assessment, Guarantee Letter operations, healthcare providers and insurance operations.
• Strong stakeholder management, problem-solving and decision-making skills.
• Experience managing escalations, service delivery and operational improvement initiatives.

Build a career with us as we help our customers and the community live Healthier, Longer, Better Lives. You must provide all requested information, including Personal Data, to be considered for this career opportunity. Failure to provide such information may influence the processing and outcome of your application. You are responsible for ensuring that the information you submit is accurate and up-to-date.

"Better" starts with people who reimagine what is possible and turn ideas into meaningful action. At AIA, you will contribute in your own way, help shape outcomes that matter and collaborate with colleagues across disciplines, teams, markets and levels. We will support you to broaden your perspective, strengthen your capabilities and grow your impact. Together, we challenge assumptions, learn from one another and find better ways forward. Bring your ambition, experience and ideas to AIA, and help shape what “better” looks like.

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