Receiving and processing new applications for coverage and handling customer service issues.
Maintaining claim databases, including information about claim status, payouts, and related details
To assist members with medical claims management and hospital admission support.
To process medical claims submissions received competently within the stipulated turnaround time (TAT) and in accordance with the standard operating procedure (SOP).
To process medical claims competently within the stipulated turnaround time and in accordance with claims protocol.
To attend to claims enquiries and correspondences relating to feedback or complaints promptly and effectively.
To follow-up and ensure all requests for supporting documents and/or information relevant to the assessment of a claim are promptly obtained from clients.
To investigate potential fraudulent claims and report any suspicion of an irregularity to the superior.
To perform any ad hoc tasks assigned by the superior.

Essential Experience, Skills And Knowledge:

Candidate must possess at least a Diploma, Advanced/Higher/Graduate Diploma, Bachelor’s Degree, Professional Certificate in Medical Science/Nursing/Pharmacy/Insurance or any related field.
Candidate with technical knowledge of medical claims or relevant working experience in Third Party Administration (TPA) / Insurance Industry will be an added advantage.
Good command in English & Bahasa Malaysia, both speaking and writing.
Able to work in fast paced environment, independent, customer focused and proactive working attitude with strong sense of responsibility.
Must be computer literate with knowledge of office applications such as Word, Excel, etc.
Flexible and willing to work extra hours as and when required.
Possess own transport.

Job Type: Contract
Contract length: 12 months

Pay: RM2,000.00 - RM2,500.00 per month

Schedule:

Education:

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