Talent.com
CLAIMS EXECUTIVE / ASSISTANT

CLAIMS EXECUTIVE / ASSISTANT

Compumed ServicesKuala Lumpur, Kuala Lumpur, Malaysia
2 hari lalu
Penerangan pekerjaan

Job Scope

  • 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.
  • 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-hospitalisation, hospitalisation and post-hospitalisation.
  • Prepare complete documents for submission of claims to the insurance company.
  • Update the status of members during hospitalisation.
  • Attend to inquiries from insurance companies and service providers with regards to the Company’s operating procedures.
  • Attend to inquiries and liaise with members regarding reimbursement procedures.
  • Assist the Call Centre Team and support to the new recruits in the Company.
  • Subject to working night 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.
  • Perform relief task as and when required by the Management.
  • Maintain a proper filing system.

Job Specification

  • At least STPM / "A" Level / Pre-U / Diploma / Degree or equivalent in any field.
  • Experience in medical / life insurance claims, hospital services, and clinical services.
  • 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.
  • #J-18808-Ljbffr

    Buat amaran kerja untuk carian ini

    CLAIMS EXECUTIVE / ASSISTANT • Kuala Lumpur, Kuala Lumpur, Malaysia