Senior Medical Benefits Claims Analyst

AIA; Kuala Lumpur; Hybrid; MYR 60,000 - 90,000; Full time

Job summary

AIA Shared Services in Kuala Lumpur is seeking a qualified professional to adjudicate claims, verify medical documentation and assemble information for timely loss assessment and payment. You will pre-certify documents, ensure policy coverage and compliance with guidelines while maintaining strict confidentiality.

Ideal candidates have 5+ years in the insurance/medical sector, strong communication, analytical skills and the ability to multi-task in a fast-paced environment with minimal

Qualifications

• Bachelor’s degree or equivalent, in any field of study or with relevant background.
• Minimum of 5 years working experience preferably in the insurance or medical industry.
• Candidate with medical insurance/nursing/medical science/hospital background will be added advantage.
• Able to work in fast paced environment, independent, customer focused, result oriented & disciplined.

Responsibilities

• Ensure completeness of Claims / Guarantee Letter.
• Pre-certify documents in compliance to Company’s requirements and guidelines.
• Adjudicate medical claims by following the organization guidelines & within the assigned authority limit.
• Establish covered medical insurance losses against benefits coverage and eligibility.
• Establish proof of loss by studying medical documentation; assembling additional information as required.

Skills

Communication skills

Multitasking

Adaptability

Analytical thinking

Education

Bachelor’s degree or equivalent

Tools

Microsoft Office

Reporting tools

Job description

AIA Shared Services in Kuala Lumpur is seeking a qualified professional to adjudicate claims, verify medical documentation and assemble information for timely loss assessment and payment. You will pre-certify documents, ensure policy coverage and compliance with guidelines while maintaining strict confidentiality.

Ideal candidates have 5+ years in the insurance/medical sector, strong communication, analytical skills and the ability to multi-task in a fast-paced environment with minimal