Senior Manager, Individual Benefit Cashless Claim

AIA Malaysia; Kuala Lumpur; On-site; MYR 180,000 - 280,000; Full time

Job summary

AIA Malaysia is seeking a senior operations leader to oversee end-to-end Cashless Medical Claims and Guarantee Letter (GL) operations for Individual Business and Employee Benefits portfolios in Malaysia. The role emphasizes timely, accurate claim decisions, strong stakeholder collaboration, and a focus on operational efficiency and customer experience.

The ideal candidate has 8+ years in medical claims or healthcare administration and at least 3 years of leadership experience, with deep

Qualifications

• 8+ years experience in medical claims, cashless operations or healthcare administration.
• 3+ years leadership experience managing operational teams.
• Strong knowledge of medical claims assessment, GL operations, healthcare providers and insurance operations.

Responsibilities

• Manage end-to-end Cashless Medical Claims and GL operations for IB and Additional Guarantee requests for IB & EB portfolios.
• Ensure timely, accurate and compliant claim decisions and strong stakeholder collaboration.
• Lead, coach and develop team leaders to achieve service objectives and drive improvements.
• Collaborate with stakeholders including Contact Centre, Branches, Customer Service, Technology, Takaful, Underwriting, Claims and Medical Management.
• Drive process improvements and automation initiatives to enhance efficiency and customer experience.
• Prepare and present operational performance reports and service metrics.

Skills

Leadership

Stakeholder management

Performance management

Process improvements

Project management

Education

Degree in Insurance/Healthcare/Business Administration

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.