Senior Claims Executive
3 days ago
Location: OUG Parklane, Malaysia
Job Titles: Junior Claims Executive / 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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