Individual Claims Management, Analyst
Found in: Talent MY C2 - 1 week ago
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
Responsible for performing pre-certification; prospective, concurrent and retrospective review of hospitalization.Roles and Responsibilities:
To support a team of assessors in pre-certification, hospitalization, case management in the issuance of guarantee letter in compliance to Company’s requirements and guidelines. To ensure quality audits are done for the respective team members. To ensure guarantee letters are issued accurately and correctly in timely manner and with authority assigned. To assist in the assignment and monitoring of all documents received in their respective team’s queues. To ensure that cases of fee disputes are handled and resolved within targeted TAT. To reduce error rate in guarantee letter issuance less than the target. To perform other responsibilities and duties periodically assigned by supervisor in order to meet operational and/or other requirements.Minimum Job Requirements:
Candidate must possess at least a Bachelor's Degree, Post Graduate Diploma, Professional Degree or Master's Degree in Dentistry, Medicine, Medical Science, Biomedical, Nursing, Pharmacy, Pharmacology, Physiotherapy or equivalent. Candidate with claim experience is an added advantage. Fresh Graduate with medical background is encouraged to apply. Technical Skills: Claims assessment, Medical report knowledge, Health Insurance Policy knowledge. Industry: Health Insurance, Third-Party Administrator, Hospitals, Clinics, Medical Labs. Language: English and Bahasa Malaysia.-
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