CLAIMS EXECUTIVE / ASSISTANT - with Growth Opportunities

JOB SCOPE (Major Responsibilities of this job)

• 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 complied 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

JOB SPECIFICATION

• Degree in any related field (Medical Science, Nursing, Insurance, etc)
• Passed Insurance professional examination such as ICA and FLMI would be an advantage
• Experience in claims adjudication is an advantage
• 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 it application is an added advantage
• Good spoken and written communication skills in Bahasa Malaysia & English
• Those with medical/life insurance claims, hospital services, and clinical services experience
• Knowledge of insurance/medical terminologies and insurance policy.
• Communication and interpersonal skills.
• Computer Literate
• Working experience in TPA, insurance or healthcare industry
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