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Quality Reviewer (Medical Pre-Underwriting - Health Insurance)
CognizantKuala Lumpur, Malaysia7 days ago
Job descriptionBachelor's degree in Life Sciences, Nursing, Healthcare Administration, or related field. 3-5 years of experience in health insurance underwriting or quality assurance. Strong knowledge of Hong Kong's health insurance regulatory framework. Fluency in Cantonese, Mandarin, and English (speak, read, and write) .
Responsibilities
and Expectations :
- Conduct quality audits of underwriting decisions made by processors.
- Ensure adherence to underwriting guidelines and regulatory standards.
- Identify trends in processing errors and rmend corrective actions.
- Collaborate with training teams to address knowledge gaps.
- Review escalated cases for accuracy andpleteness.
- Maintain audit logs and prepare quality reports for management.
- Ensurepliance with IA regulations and internal audit protocols.
- Assist in updating standard operating procedures based on audit findings.
- Support continuous improvement initiatives in underwriting workflows.
- Provide feedback to processors to enhance accuracy and efficiency.
- Participate in system testing for underwriting rule updates.
- Ensure confidentiality and integrity of medical data during reviews.
Academic and Additional Qualifications Needed :
About Cognizant :
Cognizant (Nasdaq : CTSH) engineers modern businesses. We help our clients modernize technology, reimagine processes and transform experiences so they can stay ahead in our fast-changing world. Together, we're improving everyday life. See how at cognizant or @cognizant .
Job ID 46239
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Quality • Kuala Lumpur, Malaysia