Claims Investigation Executive

4 weeks ago


Malaysia Allianz General Insurance Company Full time

Are you looking for something different instead of more of the same?

In your new role, you will process health claims while ensuring that our department’s strategic initiatives support the company’s mission and business goals, with a focus on risk mitigation and fraud prevention.

You'll be responsible for:

  1. Processing and assessing health claims, particularly in investigation cases.
  2. Identifying and flagging potential abuses or suspected fraud during claim assessments.
  3. Assessing health claims for potential non-disclosures or pre-existing conditions, and developing strategies to gather evidence.
  4. Meeting targets for cost avoidance.
  5. Reviewing and resolving outstanding investigation claims.
  6. Liaising with customers, agents, and doctors to facilitate claim settlements.
  7. Ensuring claims are processed within the department’s specified turnaround time.
  8. Drafting and sending correspondence independently.

Important for your success:

  1. Graduate in bio-medical science or any science related studies is an added advantage.
  2. 2 years in health claims is an added advantage.
  3. Knowledge in medical terms/medical related studies is an added advantage.
  4. Experience in claims investigation.
  5. Good communication skills in both written and verbal.
  6. Ability to think out of box.

55728 | Customer Services & Claims | Professional | Allianz Malaysia | Full-Time | Permanent

Allianz Group is one of the most trusted insurance and asset management companies in the world. Caring for our employees, their ambitions, dreams and challenges, is what makes us a unique employer. Together we can build an environment where everyone feels empowered and has the confidence to explore, to grow and to shape a better future for our customers and the world around us.

We at Allianz believe in a diverse and inclusive workforce and are proud to be an equal opportunity employer. We encourage you to bring your whole self to work, no matter where you are from, what you look like, who you love or what you believe in.

We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, disability or sexual orientation.

Great to have you on board. Let's care for tomorrow.

#J-18808-Ljbffr

  • Malaysia Allianz General Insurance Company Full time

    We're seeking a skilled Health Claims Processor to join our team. In this role, you'll process health claims while ensuring our department's strategic initiatives support the company's mission and business goals. Key responsibilities include processing and assessing health claims, identifying potential abuses or suspected fraud, and meeting targets for cost...


  • Malaysia Allianz General Insurance Company Full time

    Process health claims, identify potential abuses, and ensure strategic initiatives align with company goals, focusing on risk mitigation and fraud prevention. Key Responsibilities:Process and assess health claims, particularly in investigation cases. Identify and flag potential abuses or suspected fraud during claim assessments. Assess health claims for...


  • Malaysia Chubb Full time

    Key Objectives This role will be responsible for analyzing, evaluating, and determining the validity of insurance claims by conducting thorough investigations and working closely with stakeholders to ensure a fair and accurate resolution. This position works closely with country Claims teams and Regional Fraud & SIU team. Duties and responsibilities -...


  • Malaysia Combined Insurance Full time

    Key Objectives This role will be responsible for analyzing, evaluating, and determining the validity of insurance claims by conducting thorough investigations and working closely with stakeholders to ensure a fair and accurate resolution. This position works closely with country Claims teams and Regional Fraud & SIU team. Duties and responsibilities -...

  • Claims Siu Manager

    4 months ago


    Malaysia Chubb Full time

    This role will be responsible for analyzing, evaluating, and determining the validity of insurance claims by conducting thorough investigations and working closely with stakeholders to ensure a fair and accurate resolution. This position works closely with country Claims teams and Regional Fraud & SIU team. Duties and responsibilities - Conduct...


  • Malaysia AIA Full time

    Process medical claims efficiently, ensuring timely and accurate reimbursement, while maintaining high quality and productivity standards. Junior/Senior Medical Claims Executive (SG Market) - 1 year contract Process reimbursement claims cases to meet department requirements and benchmarks. Evaluate and gather all data for claim processes,...

  • Associate, Invoice

    5 months ago


    Malaysia Lazada Full time

    Location: **Malaysia** - Department: Supply Chain & Logistics- Location: Malaysia- Team and Role Introduction: - The Claims & Invoice Analyst is responsible in managing the day-to-day tasks in communicating claims & Invoice report to third-party logistics(3PLs) and close collaboration with finance in managing 3PLs’ claim payments. Subsequently, this role...


  • Malaysia AIA Full time

    Junior / Senior Medical Claims Executive (SG Market) - 1 year contract Skip to content Process reimbursement claims cases to meet department requirements & benchmarks. Evaluate and gather all data for claim processes, prepare medical questionnaire and to review all status and ensure efficient adjustment in claim system. Ensure that targets are met for...


  • Malaysia United Overseas Bank Ltd. Full time

    Lead a team of investigators in AML Transaction Monitoring Systems and Unusual Activity Reports review and closure. United Overseas Bank Limited (UOB) is a leading bank in Asia with a global network of around 500 offices in 19 countries and territories in Asia Pacific, Europe and North America. Our purpose is to build the future of ASEAN. Our values are...


  • Malaysia American International Group Full time

    Manage a portfolio of 1,500 claims annually, assessing vehicle damage, determining repair methodologies, and engaging with stakeholders to resolve claims efficiently. Auto Material Damage Claims Technical Controller Location: Kuala Lumpur Time Type: Full time Job Description: To handle a portfolio of 1,500 p.a. claims for Personal Lines products which...


  • Malaysia American International Group Full time

    Auto Material Damage Claims Technical Controller page is loaded Auto Material Damage Claims Technical Controller Location: Kuala Lumpur Time Type: Full time Job Requisition ID: JR2402365 Description To handle a portfolio of 1,500 p.a. claims for Personal Lines products which includes quantum assessment of consumer auto claims. Core activities would...


  • Malaysia United Overseas Bank Ltd. Full time

    Press Tab to Move to Skip to Content Link Select how often (in days) to receive an alert: AML Investigation, Team Lead Posting Date: 30 Jul 2024 Location: Kuala Lumpur, Wilayah Persekutuan, 59200 Company: UOB Innovation Hub 2 Sdn. Bhd. About UOB United Overseas Bank Limited (UOB) is a leading bank in Asia with a global network of around 500 offices in...


  • Malaysia AIA Full time

    Process medical claims, evaluate data, and ensure efficient adjustments. Evaluate medical reports, meet KPI goals, and correspond with hospitals. 1-year contract, education in Biomedical or related fields. Self-motivated and customer-driven. Sound problem-solving skills.


  • Malaysia Hernan Corporation Full time

    Welcome to our new URL – jobstreet.com.my is now my.jobstreet.com . SIGN IN now for the same great experience. Learn more . Account Executive/Senior Account Executive Skip to content Account Executive/Senior Account Executive Product costing, profitability studies, analysis Support month-end closing and reporting Any other tasks as per assigned...


  • Malaysia BDO Full time

    Seeking Executive/Senior Executive in Business Services & Outsourcing to provide full accounting and back-office support to clients in Kuala Lumpur. Requirements include a recognized degree in Accounting, at least 4 years of experience in finance, and proficiency in various accounting software packages. Additional skills include competent MS Office...

  • Marketing Executive

    1 month ago


    Malaysia Zurich 56 Company Ltd Full time

    Marketing Executive Job Summary: To drive growth and profitability in all assigned products through risk selection, pricing, negotiation, sales, retention, and quality service. Job Accountabilities - Key Accountabilities Actively manage daily work processes of designated territory to achieve operational and strategic objectives. Analyze needs, develop...

  • Marketing Executive

    1 month ago


    Malaysia Zurich 56 Company Ltd Full time

    Marketing Executive Job Summary: To drive growth and profitability in all assigned products through risk selection, pricing, negotiation, sales, retention, and quality service. Job Accountabilities - Key Accountabilities Actively manage daily work processes of designated territory to achieve operational and strategic objectives. Analyze needs, develop...

  • Marine Cargo Surveyors

    5 months ago


    Malaysia Mestari Adjusters Sdn Bhd Full time

    **Key responsibilities**: - Surveying the damaged goods, negotiating on the consignees claimed amount - Suggesting to the consignees in view of loss minimization or to avoid aggravation of loss - Submitting preliminary loss advise to the Insurers within 24 hours - Advising the consignee and wherever necessary act, to protect the rights of recovery against...

  • Executive, Finance

    4 months ago


    Malaysia FFM Berhad Full time

    **Golden Screen Cinemas Sdn Bhd | Damansara Jaya, Petaling Jaya, Selangor.** **Join the largest cinema exhibitor and leading film distributor in Malaysia!** **You will play an important role in**:deliver accounts on time measure through speed, accuracy, and cost by educating, implementing, and monitoring of Internal Control System. Key Roles &...


  • Malaysia Hernan Corporation Full time

    Welcome to our new URL – jobstreet.com.my is now my.jobstreet.com. SIGN IN now for the same great experience.Account Executive/Senior Account ExecutiveProduct costing, profitability studies, analysisSupport month-end closing and reportingOther tasks as per assigned (AP, AR, intercompany transactions, investigate variances, etc.)Requirements:Min. degree in...