The Medical Helpdesk Support is responsible for reviewing and assessing medical claims from a clinical perspective to ensure treatments, diagnoses, and hospitalizations are appropriate and aligned with medical guidelines and company policies. The role supports pre-approval requests, reviews medical records and supporting documents, and works closely with hospitals and internal teams to clarify claim information and support claim decisions.

The role requires strong clinical judgment, attention to detail, and the ability to interpret medical information while helping ensure a fair, accurate, and efficient claims assessment process.

Position Responsibilities:

• Review and assess medical claims (reimbursement, and cashless) from a clinical perspective.
• Validate appropriateness of diagnosis, treatment, and hospitalization based on nursing and medical guidelines.
• Support pre-approval (pre-authorization) processes for hospital and non-hospital cases.
• Assess medical necessity, length of stay, and treatment plans.
• Analyze medical records, discharge summaries, and supporting documents.
• Ensure completeness and accuracy of claim documentation.
• Assist in reviewing medical disputes and appeal cases.
• Provide clinical input to support claim decisions.
• Follow up on incomplete or unclear documentation.
• Identify potential overutilization, irregular treatment patterns, or inconsistencies in claims.
• Escalate complex or high-risk cases to Medical Doctor (if required).
• Ensure all claim assessments are in line with company policies, clinical guidelines, and regulatory requirements.
• Candidates with a medical background will be preferred.

Required Qualifications:

• Bachelor’s Degree in Healthcare, Medical Sciences, Nursing, or a related field.
• Fresh graduates or doctors with 1–2 years of clinical experience are welcome to apply.
• Experience as a General Practitioner, internship doctor, or in a hospital/clinic setting is an advantage.
• Good understanding of medical diagnoses, treatment plans, and hospitalization practices.
• Able to review and interpret medical records, laboratory results, and clinical documentation.
• Strong analytical and problem-solving skills.
• Detail-oriented with good documentation and reporting skills.
• Good communication skills and ability to work with multiple stakeholders.
• Proficient in Microsoft Office applications.
• Interest in insurance claims, managed care, or medical case assessment is preferred.

Preferred Qualifications:

• Solid interpersonal skills to effectively build relationships and communicate with other departments

When you join our team:

• We’ll empower you to learn and grow the career you want.
• We’ll recognize and support you in a flexible environment where well-being and inclusion are more than just words.
• As part of our global team, we’ll support you in shaping the future you want to see.

About Manulife and John Hancock

Manulife Financial Corporation is a leading international financial services provider, helping people make their decisions easier and lives better. To learn more about us, visit https://www.manulife.com/en/about/our-story.html.

Manulife is an Equal Opportunity Employer

At Manulife/John Hancock, we embrace our diversity. We strive to attract, develop and retain a workforce that is as diverse as the customers we serve and to foster an inclusive work environment that embraces the strength of cultures and individuals. We are committed to fair recruitment, retention, advancement and compensation, and we administer all of our practices and programs without discrimination on the basis of race, ancestry, place of origin, colour, ethnic origin, citizenship, religion or religious beliefs, creed, sex (including pregnancy and pregnancy-related conditions), sexual orientation, genetic characteristics, veteran status, gender identity, gender expression, age, marital status, family status, disability, or any other ground protected by applicable law.

It is our priority to remove barriers to provide equal access to employment. A Human Resources representative will work with applicants who request a reasonable accommodation during the application process. All information shared during the accommodation request process will be stored and used in a manner that is consistent with applicable laws and Manulife/John Hancock policies. To request a reasonable accommodation in the application process, contact [email protected].

Hybrid