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Medical Claims Specialist - Mandarin Speaker

Medical Claims Specialist - Mandarin Speaker

AIAAIA Shared Services Malaysia, Cyberjaya, MY
30+ days ago
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

Process authorized inpatient & outpatient claims transactions within the required benchmarks.

  • Process all Inpatient, Outpatient claims and pre-approval requests received as per stipulated requirements
  • Ensure meeting individual quality, turn around time and productivity benchmark
  • Review / approve cases that exceeds subordinates’ authority
  • Respond to email enquiries from internal and external parties
  • Perform outbound call to customers when required
  • Training of new joiners on claims processing rules and products knowledge including Review and Feedback for On-The-Job training cases
  • Providing training in System Navigation and Processing Steps, towards certification with Claims Approval Authority, as stipulated in the Claims Approval Authority guidelines.
  • Conduct regular claims review in claims performance to ensure claims principles / authorities are adhered to. Review claims decision making process to identify areas of claims risk management concerns for further improvements.
  • Organize and implement team engagement activities to foster closer team spirit and create work life balance environment.
  • Performs other responsibilities and duties periodically assigned by immediate manager in order to meet business requirements

Qualifications

  • Educational background in Biomedical, Biotechnology, Nursing, Medicine, Chemistry or related fields
  • Candidate MUST able to speak Mandarin. Ability to read and write Chinese would be an added advantage.
  • Possess a minimum of 2 years experience in Medical / Life Claims processing experience
  • Comfortable working onsite in Cyberjaya 4 days a week and 1 day work from home
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    Specialist Mandarin • AIA Shared Services Malaysia, Cyberjaya, MY