Assistant Manager, Medical Claims Investigation

4 days ago

Cyberjaya, 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 ambitious people who believe in playing an important part in shaping that future. People seeking unmatched career and personal growth opportunities, who are driven to work with, and learn from some of the most inspiring and supportive leaders in the business._

Sound like you? Then read on.

About the Role
- Lead OSS SIU (Special Investigation Unit) team in management of Fraud, Waste and Abuse (FWA)
- Responsible to conduct thorough review of the customer and claims, obtaining evidence, producing report on findings as per stipulated requirements and benchmark
- Main contact point between OSS team and SG counterparts to strategize and implement processes to mitigate Fraud, Waste and Abuse (FWA) in claims
- Manage SIU team activities to meet deliverables targets for SIU
- Identify, analyze and detect suspicious fraudulent claims or abnormal behaviours by interpreting large, complex, sensitive data and transactions
- Propose mitigation plan and review processes to mitigate FWA in claims
- Conduct interviews with various parties not limited to medical doctors and claimants
- Verify claim document, analyze signs of potential forged documents and clarification with hospital
- Gather all information and prepare preliminary investigation report to Fraud Team (SG)
- Provide training session to claims assessors on fraud detection and best practices
- Performs other tasks periodically and/or adhoc assigned to meet operational and/or other requirements
- Provide report and update of FWA cases on monthly basis
- Build a career with us as we help our customers and the community live Healthier, Longer, Better Lives._

  • Assistant Manager, Medical Claims Investigation

    1 week ago

    Cyberjaya, Selangor, 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...

  • Claims Investigator Insurance Industry Mnc

    2 months ago

    Cyberjaya, Malaysia Agensi Pekerjaan Times Management Consultancy Sdn Bhd Full time

    _ **Responsibilities**:_ - Assess customer profiles, policy details and claim history (all policies). - Review claim patterns/trends nature of injuries, treating doctors, clinic address and residential/workplace. - Conduct interviews with the servicing agent, medical doctors and claimant. - Verify claim document, analyze signs of potential forged documents...

  • Assistant Manager-claims

    4 weeks ago

    Cyberjaya, 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...

  • Assistant Manager-claims

    1 week ago

    Cyberjaya, Selangor, 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...

  • Medical Claims Assessor

    1 week ago

    Cyberjaya, Selangor, Malaysia Brandt International Sdn Bhd Full time

    Responsibilities: Process all Life and/or A&H/Major claims requests received as per stipulated requirements Register, reserve, assess, review, investigate, approve and process payment for Major claims within own Claims Approval Authority and recommend to higher level for claims above authority Evaluate and gather all data for claim processes, prepare medical...

  • Claims Investigator Insurance Industry Mnc

    1 week ago

    Cyberjaya, Selangor, Malaysia Agensi Pekerjaan Times Management Consultancy Sdn Bhd Full time

    _Responsibilities:_ Assess customer profiles, policy details and claim history (all policies). Review claim patterns/trends nature of injuries, treating doctors, clinic address and residential/workplace. Conduct interviews with the servicing agent, medical doctors and claimant. Verify claim document, analyze signs of potential forged documents and...

  • Medical Claims Assessor

    4 days ago

    Cyberjaya, Malaysia Brandt International Sdn Bhd Full time

    **Responsibilities**: - Process all Life and/or A&H/Major claims requests received as per stipulated requirements - Register, reserve, assess, review, investigate, approve and process payment for Major claims within own Claims Approval Authority and recommend to higher level for claims above authority - Evaluate and gather all data for claim processes,...

  • Medical Claim Assessor

    1 week ago

    Cyberjaya, Selangor, Malaysia Agensi Pekerjaan TalentStrive Asia Sdn Bhd Full time

    Job Descriptions: Process all Life and/or Accident & Health/Major claims requests received as per stipulated requirements. Evaluate and gather all data for claim processes, prepare medical questionnaires, and review all statuses to ensure efficient adjustments in the claim system. Ensure meeting individual quality, turnaround time, and productivity...

  • Medical Claims Assessor

    1 week ago

    Cyberjaya, Selangor, 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...

  • Specialist - Claims

    5 days ago

    Cyberjaya, 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...

  • Medical Claim Assessor

    3 days ago

    Cyberjaya, Malaysia Agensi Pekerjaan TalentStrive Asia Sdn Bhd Full time

    Job Descriptions: - Process all Life and/or Accident & Health/Major claims requests received as per stipulated requirements. - Evaluate and gather all data for claim processes, prepare medical questionnaires, and review all statuses to ensure efficient adjustments in the claim system. - Ensure meeting individual quality, turnaround time, and productivity...

  • Claims Specialist

    3 weeks ago

    Cyberjaya, 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...

  • Insurance Medical Claims

    3 weeks ago

    Cyberjaya, Malaysia Agensi Pekerjaan Hiredsearch Services Sdn Bhd Full time

    Process all Life / Accident and Health (A&H) / Major Claims / Corporate Solutions (CS)/ Pre Approval (PA) claims requests received as per stipulated requirements. - Evaluate and gather all data for claim processes, prepare medical questionnaire and to review all status and ensure efficient adjustment in claim system. - Ensure meeting individual quality,...

  • Insurance Medical Claims Permanent Cyberjaya

    1 week ago

    Cyberjaya, Selangor, Malaysia Agensi Pekerjaan Hiredsearch Services Sdn Bhd Full time

    Process all Life / Accident and Health (A&H) / Major Claims / Corporate Solutions (CS)/ Pre Approval (PA) claims requests received as per stipulated requirements. Evaluate and gather all data for claim processes, prepare medical questionnaire and to review all status and ensure efficient adjustment in claim system. Ensure meeting individual quality,...

  • Assistant Manager-claims

    3 weeks ago

    Cyberjaya, 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...

  • Major Claims Specialist

    1 week ago

    Cyberjaya, Selangor, 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...

  • Associate - Claims

    4 weeks ago

    Cyberjaya, 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...

  • Assistant Manager, Claims

    1 week ago

    Cyberjaya, Selangor, 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...

  • Medical Claims Assessor

    2 weeks ago

    Cyberjaya, 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...

  • Associate - Claims

    1 week ago

    Cyberjaya, Selangor, 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...