Apac Quality Management Prepay Claim Audit

4 days ago


Kuala Lumpur, Malaysia The Cigna Group Full time

**RESPONSIBILITIES**
- Perform audits on Prepay claims to determine accuracy, consistency, and compliance regarding established procedures.
- Proactively flag possible issues and risks.
- You may participate in focus audits, projects and third-party.
- You may perform root cause analysis on audit findings to understand why the findings occurred and communicate those in the monthly meetings with Operations.
- Identifies improvements to both audit and operational processes and procedures.
- Assists in the development of audits and audit processes and procedures.
- Support auditors in other audit lines with specific language knowledge and cross support when required.

**SCOPE AND DIMENSIONS**
- Reports directly to the Quality Management Supervisor.
- Audits communications across EGS regions, primarily AP Claim.

**EXPERIENCE REQUIRED**
- Ideally AP Claims experience of at least 2 years and familiar with Eurocare.
- Experience in audit, training, review, or coaching would be beneficial.

**YOUR PROFILE**
- High energy, results-oriented individual able to coordinate and prioritize multiple tasks to meet deadlines.
- Ability to think analytically, interpret information / observations and make effective decisions.
- Ability to ask for guidance, when required, on complex issues.
- Professional verbal and written communication skills.
- You have proficient knowledge of at least English.
- Ability to listen attentively, build rapport, and ask structured open / closed questions.
- Ability to present information and ideas in a confident, creative and interactive manner.
- Ability to explain audit findings and trends and provide constructive feedback; work patiently and effectively with staff of different experience levels, learning styles and cultural diversity.
- Ability to provide constructive coaching to fellow Auditors to share knowledge and skills.
- Ability to work effectively on their own and as part of a team.
- Mindful of the needs of the business, the clients and the personal needs of the person being audited.

**About The Cigna Group**

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.


  • Prepay Claims Auditor

    10 hours ago


    Kuala Lumpur, Malaysia The Cigna Group Full time

    **Quality Management** **Auditor** **YOUR JOB** - Perform audits on Prepay claims to determine accuracy, consistency, and compliance regarding established procedures. - Proactively flag possible issues and risks. - You may participate in focus audits, projects and third-party. - You may perform root cause analysis on audit findings to understand why the...

  • Audit Assistant

    1 week ago


    Kuala Lumpur, Malaysia SC Tax Audit Full time

    Assist in clients' audit engagements, including planning, executing, and completing all levels of engagements. - Acquire a working knowledge of the client’s business, prepare and analyze financial statements, and audit-related issues. - Interact with client’s management to gather information, resolve problems and make recommendations for business and...


  • Kuala Lumpur, Malaysia The Cigna Group Full time

    Claims processing - Processing claims under GEH APAC book of business - Assessing and processing claims for medical expenses while always bearing in mind the importance of medical confidentiality. - Positioning him/herself analytically and critically in the context of cost management and in respect of existing working methods. - Following up his/her own...


  • Kuala Lumpur, Malaysia TikTok Full time

    Responsibilities About Us TikTok is the leading destination for short-form mobile video. Our mission is to inspire creativity and bring joy. TikTok has global offices including Los Angeles, New York, London, Paris, Berlin, Dubai, Singapore, Jakarta, Seoul and Tokyo. Why Join Us Creation is the core of TikTok's purpose. Our platform is built to help...


  • Kuala Lumpur, Malaysia Aon Corporation Full time

    Posting Description: **Risk Project Manager (APAC)** We’re hiring! We are looking for a Risk Project Manager (APAC) to join our APAC Risk function, reporting into the APAC Chief Risk Officer. This position represents an exciting opportunity to help frame the risk based decisions of the APAC business. Are you a driven, organized, goals focused project...

  • Claims Administrator

    10 hours ago


    Kuala Lumpur, Malaysia MS Amlin Full time

    **Claims Administrator**:**Kuala Lumpur**: **Division**:MS AUL Claims **Department**:Claims Shared Services **Reports To**:Assistant Claims Manager **1. Purpose** Working as a member of the Claims team, the Claims Administrator supports the efficient and effective processing of activities which support the on-going management of an open claims portfolio...

  • Audit Quality

    4 days ago


    Kuala Lumpur, Malaysia Anradus Pte Ltd Full time

    Industry/ Organization Type: Accounting Firm (Global) - Position Title**:Quality & Risk Management Manager/ QRM Manager**: - Working Location: Central - Working Hours**:5 days, Monday - Friday (8:45 AM - 5:30 PM)**: - Salary Package**:Basic up to $ 9,000 + Performance Bonus**: - Duration: Permanent **Key Responsibilities** - Support the Head of QC in all...


  • Kuala Lumpur, Malaysia Boston Scientific Corporation Full time

    **Work mode**:Hybrid**Onsite Location(s)**:Kuala Lumpur, 14, MY**Purpose Statement** The role of Compliance Associate is to provide compliance advice and support to franchises across the APAC Boston Scientific business. In this role, you will oversee the review and approval process of the company’s interactions with healthcare professionals across the...


  • Kuala Lumpur, Malaysia AIA Full time

    At AIA we’ve started an exciting movement to create a healthier, more sustainable future for everyone. - It’s about finding new ways to not only better people's lives, but to better the communities and environments we live in. Encompassing our ambition of helping a billion people live Healthier, Longer, Better Lives by 2030._ - And to get there, we need...

  • Manager Operations

    1 week ago


    Kuala Lumpur, Malaysia FedEx Express APAC Full time

    Ramp/ Air Operations (P&P and Audits), Ramp & Gateway Operations, Air Feeder Linehaul, Air Network Support, Linehaul (Cross-Border, In-Country), Hub Operations, Operations Support, Air Operations, Hub & Gateway Operations, Ramp Operations, Cross Border Linehaul, On Road, Handling, Property & Facilities, Dispatch, Service Assurance, Network Control, Transport...

  • Payroll Manager

    10 hours ago


    Kuala Lumpur, Malaysia Dentsu Aegis Network Full time

    As a region, we currently operate under a decentralized payroll model. We are presently in the initial stages of constructing a region-wide payroll roadmap. This roadmap addresses any necessary remediations while also outlining the longer-term operating model and platform strategy. This role will be divided into two phases. Initially, this role will focus on...


  • Kuala Lumpur, Malaysia The Cigna Group Full time

    **JOB PURPOSE** The job holder is responsible of serving providers and insurance companies by determining requirements, answering inquiries, resolving problems, fulfilling requests and maintaining database. He/She is responsible for processing as per terms of benefits. He/She should provide accurate and relevant medical coverage details and maintain...


  • Kuala Lumpur, Malaysia The Cigna Group Full time

    POSITION : Claims Representative REPORTING TO : Claims Senior Representative / Supervisor 1. JOB PURPOSE The job holder is responsible of serving providers and insurance companies by determining requirements, answering inquiries, resolving problems, fulfilling requests and maintaining database. He/She is responsible for processing as per terms of...


  • Kuala Lumpur, Malaysia cbs APAC Full time

    cbs India is the subsidiary of cbs, a leading international consultancy headquartered in Heidelberg, Germany. We deliver high-end quality consulting and technology services to large industrial corporations that run SAP. We are looking for a **e-Invoicing Consultant/Project Consultant/Service Delivery Manager **who is passionate to grow with us in the APAC...


  • Kuala Lumpur, Malaysia BAXTER Full time

    **This is where you save and sustain lives** At Baxter, we are deeply connected by our mission. No matter your role at Baxter, your work makes a positive impact on people around the world. You'll feel a sense of purpose throughout the organization, as we know our work improves outcomes for millions of patients. Baxter's products and therapies are found in...


  • Kuala Lumpur, Malaysia AGENSI PEKERJAAN HUNTERS SEARCH SDN. BHD. Full time

    Insurance claims managers lead the team of insurance claims officers to ensure they handle insurance claims properly and efficiently. They deal with more complex customer complains and assist with fraudulent cases. Insurance claims managers work with insurance brokers, agents, loss adjusters and customers. aaa Bachelor's or Equivalent

  • Bid Manager, Apac

    4 days ago


    Kuala Lumpur, Malaysia CBRE Asia Pacific Business Services Organization Full time

    At CBRE, you are empowered to take your career path into your own hands. Our people enjoy workplace flexibility in a global organization with tremendous scale providing corporate real estate and property services. Each day you will work in an inclusive and collaborative environment with supportive teammates and be challenged to grow and be your best every...

  • Claims Assessor

    3 days ago


    Kuala Lumpur, Malaysia Zurich Insurance Full time

    Job Summary- To handle single and multi-party personal or commercial line claims of moderate to high exposure and complexity within specific authority limits, to ensure that claims are handled in the most efficient, effective way while delivering a customer-centric claims service.- Job Accountabilities - Key Accountabilities- Document claims file by...

  • Claims Examiner

    3 days ago


    Kuala Lumpur, Malaysia Zurich Insurance Full time

    Job Summary- To handle single and multi-party personal or commercial line claims of moderate to high exposure and complexity within specific authority limits, to ensure that claims are handled in the most efficient, effective way while delivering a customer-centric claims service.- Job Accountabilities - Key Accountabilities- Document claims file by...


  • Kuala Lumpur, Malaysia OLIVER - APAC Full time

    **Job Title**:Assistant Finance Manager **Location**: Kuala Lumpur, Malaysia OLIVER is on the lookout for an Assistant Finance Manager based in Malaysia to join an amazing team in an exciting, fast-growing business. **WHAT YOU WILL BE DOING**: - Responsible for preparation and leading the discussion with business leads for weekly P&L reforecasts - Review...