Job title:Analyst, Individual Claims Management
Company:
Job description:At AIA we've started an exciting movement to create a healthier, more sustainable future for everyone.
Sound like you?
Then read on.
About the Role:Responsible for performing pre-certification prospective, concurrent, and retrospective review of hospitalization and to ensure that cost containment measures are carried out without compromising on the care quality and service standards.
Roles and Responsibilities:Support and lead a team of assessors in pre-certification, hospitalization, and case management in the issuance of guarantee letters in compliance with Company's requirements and guidelines.
Ensure quality audits are done for the respective team members.
Pre-certify cases for issuance of guarantee letters in compliance with Company's requirements and guidelines and assist the team in meeting productivity benchmarks.
Ensure guarantee letters are issued accurately and correctly within targeted TAT and with authority assigned.
Assist in the assignment and monitoring of all documents received in their respective team's queues.
Assist the WFM (workforce management) team in ensuring sufficient headcount as scheduled on the shift rotation monthly to cater for the guarantee letter process.
Ensure huddles and communications are carried out as per the agreed frequency.
Ensure coaching and engagement activities are carried out for performance improvement and cost containment.
Handle and resolve cases of fee disputes within targeted TAT.
Ensure that the error rate in guarantee letter issuance is less than the target.
Perform other responsibilities and duties periodically assigned by the supervisor to meet operational and/or other requirements.
Minimum Job Requirements:Candidate must possess at least a Bachelor's Degree, Post Graduate Diploma, Professional Degree, or Master's Degree in Dentistry, Medicine, Medical Science, Biomedical, Nursing, Pharmacy, Pharmacology, Physiotherapy, or equivalent.
Candidates with claim experience are at an advantage.
Fresh Graduates with a medical background are encouraged to apply.
Full-Time position(s) available.
Technical Skills:Claims assessment
Medical report knowledge
Health Insurance Policy knowledge
Industry:Health Insurance, Third-Party Administrator, Hospitals, Clinics, Medical Labs.
Language:English and Bahasa Malaysia.
Expected salary:
Location:Kuala Lumpur
Job posting date:Wed, 18 Sep 2024 22:06:44 GMT
Apply for the job now!#J-18808-Ljbffr