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Senior Medical Claims Executive (Healthcare Industry)

Senior Medical Claims Executive (Healthcare Industry)

Sperton Global ASSelangor, Selangor, MY
30+ days ago
Job type
  • Quick Apply
Job description

Location : OUG Parklane, Malaysia

Job Titles : Senior Claims Executive

Job Summary

The Senior Claims Executive will additionally handle complex cases, mentor junior staff, and support claims process improvements.

Key Responsibilities

  • Handle complex or high-value claims, providing in-depth analysis and investigation as necessary.
  • Review and approve claims processed by junior staff, ensuring accuracy and adherence to company policies.
  • Mentor and train junior Claims Executives on claims handling procedures and best practices.
  • Collaborate with management to implement process improvements and develop streamlined claims workflows.
  • Conduct periodic audits of claims to ensure compliance with industry regulations and internal standards.
  • Act as a primary point of contact for escalated claims issues, working closely with healthcare providers, insurers, and clients to resolve disputes.

Key Requirements

Education and Experience :

  • Diploma or bachelor’s degree in healthcare, Business Administration, Finance, or related field.
  • Senior Claims Executive : 3-5 years of experience in healthcare claims processing, with exposure to complex claims management and team leadership.
  • Familiarity with healthcare claims systems and regulations is preferred.
  • Skills :

  • Strong attention to detail and accuracy in reviewing and processing claims.
  • Excellent communication skills, with the ability to handle sensitive healthcare and financial information confidentially.
  • Proficiency in MS Office Suite, especially Excel, for record-keeping and reporting.
  • Analytical thinking and problem-solving abilities, especially for handling complex claims (Senior role).
  • Ability to work effectively in a fast-paced environment, with strong time management skills.
  • Attributes :

  • Customer-oriented with a professional demeanor in handling claims inquiries.
  • Proactive and adaptable, with a commitment to continuous improvement.
  • Leadership qualities, including the ability to mentor and guide junior staff.
  • Benefits

  • Competitive salary package with performance-based incentives.
  • Comprehensive health and wellness benefits.
  • Opportunities for professional growth and development.
  • Supportive work environment focused on innovation in healthcare services.
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