FIND YOUR 'BETTER' AT AIA

We don’t simply believe in being ‘The Best’. We believe in better - because there’s no limit to how far ‘better’ can take us.

We believe in empowering every one of our people to find their 'better' - in the work they do, the career they build, the life they live and the difference they make. So that together we can support even more people - including our own - to live Healthier, Longer, Better Lives.

If you believe in better, we’d love to hear from you.

About the Role

The Claims Medical Administrator is responsible for overseeing the processing of medical insurance claims. This role involves verifying the accuracy of claims, ensuring compliance with regulations, coordinating with healthcare providers and insurance companies, and managing the administrative tasks related to claims processing.

Key Responsibilities:

Claims Processing:

• Review and process incoming medical claims for accuracy and completeness.
• Ensure that claims are in compliance with insurance policies, government regulations, and contractual obligations.
• Input and update claim information in the claims management system.

Verification & Documentation:

• Verify patient and provider information, including insurance coverage and eligibility.
• Obtain and review necessary medical documentation to support claims.
• Maintain detailed and accurate records of all claim-related activities.

Communication & Coordination:

• Liaise with healthcare providers, insurance companies, and policyholders to resolve discrepancies and clarify claim-related information.
• Communicate claim status and decisions to relevant parties.
• Provide customer service to patients, providers, and other stakeholders regarding claims inquiries.

Compliance & Quality Assurance:

• Ensure all claims are processed in accordance with relevant laws, regulations, and company policies.
• Perform regular audits of claims to detect and prevent fraud or errors.
• Stay updated on changes in healthcare regulations and insurance policies.

Reporting & Analysis:

• Prepare and submit regular reports on claims processing activities, including trends, issues, and resolution rates.
• Analyze claim data to identify patterns, areas for improvement, and cost-saving opportunities.

Qualifications:

Education:

Bachelor’s degree in Healthcare Administration or Doctor of Medicine

Experience:

• Minimum of 2-3 years of experience in claims processing, medical billing, or a related field.
• Familiarity with healthcare insurance, medical terminology, and claims management systems.
• No Experience Required for Licensed Medical Doctors

Skills:

• Strong attention to detail and organizational skills.
• Excellent communication and customer service skills.
• Ability to work independently and as part of a team.
• Proficient in Microsoft Office Suite (Word, Excel, Outlook).
• Knowledge of relevant regulations, such as HIPAA, and compliance requirements.

MediCard is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

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.