Jobs in Kuala Lumpur, Canada

Senior Processor Executive (Insurance - Provider Relations) - Cantonese

Location: Malaysia

Language Requirement: Must have proficiency in Cantonese (Verbal and written)

Senior Processor Executive: Handle enquiries from network providers including but not limited to card acceptance / PA / outstanding claim status / contractual & fee review. Provide administrative support including but not limited to report generation / system updates & maintenance / claim status checking / calls to network providers as ad hoc request / maintenance of network summaries / voucher request handling. Provide administrative support including but not limited to report generation / system updates & maintenance / follow-up with network providers via email / communication with Claims for processing.

• Oversee and supervise subordinates in their day-to-day activities, to ensure contract compliance activities are carried out.
• Oversee and supervise subordinates on admin support and network healthcare provider data maintenance in PCMS system, to ensure contract compliance activities are carried out.

• Handle phone call and email enquiries from our network provider regarding the medical cards, pre-authorization, referrals
• Handle enquiries related to contract renewal, fee review, portal access and movement notice
• Provide information on pre-authorization status, Guarantee of Payment Letter and claims
• Update and maintain accurate records of all inquiries and provider list
• Generate different reports and network summaries on regular and ad hoc basis
• Handle movement notices and update internal systems
• Create and maintain provider records, provider related codes and contract details in internal systems
• Support onboarding of new providers
• Send notification email to internal parties on "Large Hospital Claim" cases
• Handle contract renewals and maintain system reference data
• Check claims status upon receiving enquiries from network providers
• Ensure all data entries and system updates are accurate and completed on time
• Make calls to network providers upon ad hoc request

• Oversee and supervise subordinates on day-to-day activities. Manage the Team to perform the duties accurately and efficiently.
• Monitor performance of the team to ensure delivery of agreed KPI.
• Provide regular training to staff and new joiners.
• Maintain standard operating procedures in the team up-to-date and ensure the team’s compliance to the agreed processes.
• Conduct regular communications and provide coordination with Team on the services. Establish internal escalation workflow.
• Make clear and justifiable decision and escalate to HK Team when (and only when) necessary.
• Prepare performance reporting for review on regular basis. Handle ad hoc tasks assigned by Team.

• With 1 year of experience in provider relations or health insurance
• Good communication and negotiation skills. Good analytical and problem solving skills
• Detail-minded and willing to accept new challenges
• With at least 4 years of solid experience at Team lead level in provider relations or health insurance
• Strong sense of continuous improvement and desire to deliver quality outputs; strive to over-deliver on SLAs to improve and enhance work efficiency and quality
• Exceptional communication and negotiation skills
• Strong analytical, problem solving and root cause identification skills and strong attention to detail

Cognizant (Nasdaq: CTSH) engineers modern businesses. We help our clients modernize technology, reimagine processes and transform experiences so they can stay ahead in our fast-changing world. Together, we\'re improving everyday life. See how at www.cognizant.com or @cognizant.