Senior Medical Claims Analyst (24/7 Support)

IA International Assistance Sdn Bhd; Petaling Jaya; On-site; MYR 33,000 - 61,000; Full time

Job summary

IA International Assistance Sdn Bhd is seeking a Claims Analyst to perform medical insurance claims assessment in line with Health Insurance policies and guidelines. You will review billing information for accuracy and reasonableness, investigate claims, and liaise with relevant parties to determine liability of the insurer.

You will handle incoming and outgoing calls as part of standard procedures, work in shifts (24/7), and strive to meet KPIs while ensuring compliance with regulatory

Qualifications

• Diploma in Nursing or related Allied Health qualification is required.
• Fresh graduates are encouraged to apply as stated in the posting.
• Computer literate with good command of English and BM.

Responsibilities

• Assess medical billing for correctness and completeness.
• Review the reasonableness of tests, procedures, and hospital stays.
• Investigate claims and liaise with relevant parties to determine validity.
• Process all incoming requests within service standards and regulatory requirements.
• Handle 24/7 shift rotations and meet monthly/ yearly KPIs.

Skills

English

Bahasa Malaysia

Education

Diploma in Nursing or related Allied Health

Job description

IA International Assistance Sdn Bhd is seeking a Claims Analyst to perform medical insurance claims assessment in line with Health Insurance policies and guidelines. You will review billing information for accuracy and reasonableness, investigate claims, and liaise with relevant parties to determine liability of the insurer.

You will handle incoming and outgoing calls as part of standard procedures, work in shifts (24/7), and strive to meet KPIs while ensuring compliance with regulatory