Healthcare Operations Executive

2 weeks ago

Petaling Jaya, Malaysia AXA Partners Full time

To perform basic reports analysis, claims form examination and provide recommendation on case for admission within Authority.
- Register cases into the Medical system for admission accurately and in a timely manner. This shall include the verification of customers.
- To ensure proper and complete instructions on claim eligibility are provided on claims assessment sheet for accurate and timely settlement of the claim. This shall include issue of any initial and/or final LG/NG/Deferments/Medical Enquiries following the instructions of the appointed immediate supervisor/ Healthcare Operations Seniors.
- To prepare all documentations which are relevant to the case and, to escalate to the immediate supervisor for approvals.
- Register cases into the Medical system for discharge accurately and in a timely manner.
- To process bills by allocating charges in accordance to the benefits of the customer’s policy which are stipulated in the worksheet provided. To perform basic cost containment when adjudicating claims.
- Close cases with relevant documents and information in a timely manner within the agreed SLA.
- To carry out after
- hours (8pm to 8am) assigned works. This shall include the need for verification of customer and benefits, Issuance of outpatient LG and respond to phone calls.
- To promote the best image of the company through the professional claims handling skills and strict adherence to company standards and procedures.
- Act as the first point of contact for service providers on the status of a case.

**Your Profile**
- **
Education, Professional Qualifications and Experience**
- Diploma/Degree in Management / Science/Nursing/ Medical bioscience or related field
- Qualified in or understanding of job description, KPIs, Performance evaluation
- Experience in delivering client-focused solutions based on customer needs
- Experience in Health Claim service is advantage.

**Technical/ Functional Knowledge, Skills and Abilities**
- Proficient in both spoken and written English, Bahasa Malaysia
- Proficient in Microsoft Office (Word, Excel and PowerPoint)
- Orientation, interpersonal and communication skills
- Knowledge in health insurance product Is an added advantage

**Other Role Specific Competencies**
- Ability to multi-task and work in a fast-paced environment.
- Possess good general knowledge and the ability to handle stress and work with mínimal supervision.
- Able to support shifts and OT if required.

**About AXA**

AXA Group is the world leader in insurance and asset management. We protect and advise our clients at every step in their lives, by offering products and services which satisfy their needs in the areas of insurance, personal protection, saving and asset management. AXA is the leading insurance brand worldwide, with over 100 million clients. We are transforming from payer to partner for our client, with a strong focus on risk prevention.

Our mission: Empower people to live a better life.

Our values: Customer First, Courage, Integrity and One AXA.

**About the Entity**

AXA Partners is an AXA transversal business unit offering a wide range of solutions in assistance services, travel insurance and credit protection.

AXA Partners’ role is also to implement innovative solutions emerging from the AXA Innovation unit.

Our mission is to help our Corporate clients to enrich their customers’ experience, with more than 9,000 employees at their service anywhere, anytime.

**What We Offer**

By joining AXA Partners, you will work in a responsible company, which offers a real culture of expertise & diversity. Our focus is on accelerating the development of everyone’s skills, whilst offering attractive and competitive compensation and opportunities for professional development and growth.

Additionally, at AXA, we work to make a real difference to people - when amazing things happen and when we create opportunities for a better life, the feeling of pride is extraordinary.

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