Employee Benefits Claims Management, Analyst

7 months ago

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 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

Responsible for to review and handle health/medical claims; and ensure that cost containment measures are carried out without compromising on the care quality and service standards

Roles and Responsibilities
- Ensure completeness of claims documents as per internal guideline.
- Establish covered medical insurance losses against benefits coverage and eligibility.
- Establish proof of loss by studying medical documentation; assembling additional information as required from other sources, such as claimant history, physician, employer, hospital details, type of medication, procedures & etc. Escalate questionable claims to the direct supervisor / medical advisory officers (if required).
- Resolves medical claims by approving or denying documentation; calculating benefit due; initiating payment or denial letter.
- Ensure claims are processed within the specified turnaround time
- Ensure confidentiality of all claim's information, inclusive of claims guidelines and internal controls.
- Maintains quality customer services by following customer service practices, responding to customer inquiries.
- Accomplish organization goals by accepting ownership for accomplishing new and different requests; exploring opportunities to contribute to the organization.
- Meeting individual efficiency target.
- Meeting individual quality target.
- Quality checks must be performed for every claim to ensure claims are processed and paid accurately based on benefits coverage.
- Improvement of efficiency and effectiveness of functional areas
- Ensure compliance to organization’s policies, procedures, guidelines, as well as state and federal insurance regulations.

Minimum Job Requirements
- Bachelor’s degree or equivalent, in any field of study or with relevant background.
- Fresh Graduate are welcome to apply
- Able to work in fast paced environment, independent, customer focused, result oriented & disciplined.
- Adaptable and able to work on own with mínimal direction.
- Ability to multi-task, plan optimally and meet deadlines.
- Service oriented/customers focus with sense of urgency and practice prioritization and critical thinking in jobs.
- Demonstrate good written and oral communication skills.
- Able to adapt in the face of constant changes in the organization.
- Build a career with us as we help our customers and the community live Healthier, Longer, Better Lives._

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