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JOB SCOPE (Major Responsibilities of this job)Deliver quality customer service and appropriate solutions with regards to medical/insurance claims and clinical services issues.
Provide a polite, professional and accurate response in accordance with the agreed service standards.
Liaise with hospital personnel with regards to the management of a member during pre-hospitalization, hospitalization and post hospitalization.
Prepare complete documents for submission of claims to the insurance company.
Update the status of members during hospitalization.
Attend to inquiries from insurance companies and service providers with regards the Company's operating procedures.
Attend to inquiries and liaise with members regarding reimbursement procedures.
Assist the Call Centre & Claims team and support to the new recruits in the Company.
Subject to the shifts and abiding to the duty roster prepared by the Management.
Approval of simple claims during and after office hours.
Prepare Payment Notice, Guarantee Letter & Decline Letter in daily course of duties.
To adjudicate claims for admission, outpatient and major claims.
Compile supporting documents as attachment (including police report for MVA and assault claims) with each claim submission to relevant clients.
Prepare claims borderaux for submission to client/ Finance Department together with the compiled supporting documents.
Ensure timely submission of claims and monitor closely on claims settlement timeline.
Prepare performance report & productivity report as required.
Attend to inquiries with regards to claims operating procedures at CompuMed.
Perform relief task as and when required by the Management.
Maintain a proper filing system.
JOB SPECIFICATIONAt least STPM/ 'A' Level/ Pre-U /Diploma/Degree or equivalent in any field.
Those with medical/life insurance claims, hospital services, and clinical services experience.
Knowledge of insurance/medical terminologies and insurance policy.
Working experience in healthcare, insurance or similar capacity.
High level of work commitment and strong sense of responsibility.
Good understanding of medical insurance policies and its application is an added advantage.
Good spoken and written communication skills in Bahasa Malaysia & English.
Communication and interpersonal skills.
Computer Literate.
Working experience in TPA, insurance or healthcare industry.
Application QuestionsWhich of the following statements best describes your right to work in Malaysia?
How many years' experience do you have as an executive assistant?
How many years' experience do you have as a Project Executive?
What's your expected monthly basic salary?
Which of the following Microsoft Office products are you experienced with?
Which of the following languages are you fluent in?
Are you willing to undergo a pre-employment background check?
How much notice are you required to give your current employer?
Company OverviewWe are an established business process outsourcing (BPO) provider specializing in individual and corporate employee healthcare benefit administration and management services.
We seek to recruit service-oriented individuals to deliver excellent customer service and innovative solutions to our clients.
Our VisionTo see Malaysia develop into a participative health caring culture where every citizen contributes, cares for each other and is assured of universal health benefits for life.
Our MissionTo contribute towards and promote a participative health caring culture in Malaysia by offering the best healthcare demand and supply chain management services and setting benchmarks for healthcare customer servicing.#J-18808-Ljbffr