Employee Benefits Claims Management, Analyst

Posted:
9/26/2024, 7:06:07 PM

Location(s):
Federal Territory of Kuala Lumpur, Kuala Lumpur, Malaysia ⋅ Kuala Lumpur, Malaysia

Experience Level(s):
Junior ⋅ Mid Level

Field(s):
Customer Success & Support

At AIA we’ve started an exciting movement to create a healthier, more sustainable future for everyone.

It’s about finding new ways to not only better people's lives, but to better the communities and environments we live in. Encompassing our ambition of helping a billion people live Healthier, Longer, Better Lives by 2030.

And to get there, we need ambitious people who believe in playing an important part in shaping that future. People seeking unmatched career and personal growth opportunities, who are driven to work with, and learn from some of the most inspiring and supportive leaders in the business.

Sound like you? Then read on.

About the Role

Ensure accurate and timely payment processing and approval. Strive for continuous improvement in work processes to achieve operational excellence and divisional metrics.

Roles and Responsibilities:

  • Ensure completeness of claims & Guarantee Letter (GL) documents as per internal guideline.

  • Establish covered medical insurance losses against benefits coverage and eligibility.

  • Gather information from different sources, such as medical documentation, claimant history, physicians, employers, hospital details, medications, and procedures, to advance investigations of questionable claims and Guarantee Letter (GL) requests.

  • Resolve medical claims & Guarantee Letter (GL) by approving or denying documentation; calculating benefit due; initiating payment or denial letter.

  • Ensure claims & Guarantee Letter (GL) are processed within the specified turnaround time

  • Ensure confidentiality of all claims information, inclusive of claims guidelines and internal controls.

  • Maintain quality customer services by following customer service practices; responding to customer inquiries.

  • Accomplish organization goals by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to the organization.

Minimum Job Requirements:

  • Education: Bachelor's Degree in any field of study or with relevant background

  • Years of Experience: Minimum of 3 years working experience preferably in the insurance or medical industry

  • Technical Skills: Claims assessment, Medical insurance, Medical Science

  • Industry: Health Insurance, Third-Party Administrator, Hospitals, Clinics, Medical Labs

  • Language: English and Bahasa Malaysia

  • Able to work on rotating shifts.

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.