![AIA](https://media.trabajo.org/img/noimg.jpg)
Medical Advisory, Case
4 weeks ago
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 providing technical medical expertise for claims decisions and resolution of customer enquiries and claims and managing healthcare related services provided to policy holders
- Responsibilities:
- To ensure the Fraud tool is maintained and managed with care with insightful monthly analysis.
- Well-versed with medical coding, 13th Schedule, MOH letters, reasonable and customary charges.
- To conduct AUC, regular audits, and handle escalations to identify Fraud, Waste and Abuse.
- To ensure claim adjudication is in accordance with reasonable and customary charges.
- To review trending of doctors / members / agents that may or may not be in the watch list.
- To outline process improvement, cost saving measures, combating Fraud, Waste, and Abuse methods from audits.
- To perform ad-hoc analysis to support medical advisory, agencies, corporate solutions, operations, network management, product development and other relevant departments.
- To build claim guides that collaborates with clinical guides and cost containment with effective implementation.
- To conduct robust medical training aligned with technical aspects of claims processing including training to hospitals.
- To provide Medical Advisory including disputed charges, appeals and escalations.
- To ensure projects related with audits/ analysis and cost savings are carried out within the stipulated timeline.
- To actively engage and negotiate with stakeholders for recovery and remedial actions including watchlist and non-participating list of doctors / agents / hospitals / members.
- To mentor/coach and guide the TLs and assessors in robust decision making. To proactively identify and collaborate on the needful system enhancement and process automation.
- Timely reporting and communication of all initiatives across all units in AIA. Performs other responsibilities and duties periodically assigned by supervisor in order to meet operational and/or other requirements.
- To participate and represent Medical Advisory, Case, and Fraud management in all necessary initiatives.
- Build a career with us as we help our customers and the community live Healthier, Longer, Better Lives._
-
Medical Advisory, Case
4 weeks ago
Kuala Lumpur, Malaysia AIA Full timeAt 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 Advisory, Case
3 weeks ago
Kuala Lumpur, Malaysia AIA Full timeAt 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...
-
Case Manager
2 weeks ago
Kuala Lumpur, Malaysia Aspen Medical Full timeAspen Medical seeks expressions of interest in Case Manager for an upcoming opportunity for occupational and industrial health services. **Locations**: PNG, Fiji, Indonesia, Vanuatu, Malaysia, Vietnam, Philippines, Kiribati **Responsibilities may include; but not limited to**: - Able to manage complex case management referrals and issues, in consultation...
-
Case Reviewer
1 week ago
Kuala Lumpur, Malaysia EXIMIUS MEDICAL ADMINISTRATION SOLUTIONS SDN BHD Full time1. To be well versed with the MOH Fee schedule 2. To review admission & discharges bill. 3. To work closely with PAT to achieve TAT of admission & discharge 4. To review unnecessary medicine, test and procedure in the billing. 5. To conduct investigation/audit on patients via phone calls. 6. To prepare discharge report fortnightly. 7. To report and update...
-
Medical Advisory, Case
2 weeks ago
Kuala Lumpur, Malaysia AIA Full timeAt 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...
-
Advisory Internship for Medical Claims
6 days ago
Kuala Lumpur, Kuala Lumpur, Malaysia AIA Malaysia Full timeInternship Opportunity in Medical Claims and AdvisoryAIA Malaysia offers an internship program in medical claims and advisory. This internship provides an excellent opportunity for students to gain practical knowledge of the business area, the company, and the industry.The successful candidate will be responsible for consolidating reports, performing...
-
Medical Claims Advisory Intern
6 days ago
Kuala Lumpur, Kuala Lumpur, Malaysia AIA Malaysia Full timeMedical Claims and Advisory InternshipAIA Malaysia is embarking on an exciting movement to create a healthier, more sustainable future for everyone. Our goal is to better people's lives, the communities, and environments we live in.We are seeking highly motivated individuals to join our team as medical claims and advisory interns. This internship will...
-
Internship in Medical Claims and Advisory
6 days ago
Kuala Lumpur, Kuala Lumpur, Malaysia AIA Malaysia Full timeMedical Claims and Advisory RoleAIA Malaysia is committed to creating a healthier, more sustainable future for everyone. To achieve this goal, we need talented individuals to join our team as medical claims and advisory professionals.This role involves supporting the day-to-day activities of a particular area of the business on either a full-time or...
-
Medical Advisory, Case
3 weeks ago
Kuala Lumpur, Malaysia AIA Full timeAt 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...
-
Case Specialist
4 weeks ago
Kuala Lumpur, Malaysia Hunters International Sdn Bhd Full time**About t****he Company** Our client is a global medical and travel security services company. They p***rov***ide assistance to organizations and individuals around the world. Our client specializes in health and security risk management, offering a range of services to help clients navigate and respond to various challenges while traveling or...
-
Kuala Lumpur, Malaysia Asia Medical Advisory Full time**Key Responsibilities**: - Draft, edit, and proofread comprehensive medical reports based on consultations and medical records. - Ensure accuracy, clarity, and compliance with medical terminology and standards. - Collaborate closely with the specialist doctor to capture critical information and insights. - Manage multiple tasks and prioritize workload to...
-
Case Management Expert
6 days ago
Kuala Lumpur, Kuala Lumpur, Malaysia AIA Hong Kong and Macau Full timeAt AIA, we're committed to creating a healthier and more sustainable future for everyone. Our goal is to help a billion people live Healthier, Longer, Better Lives by 2030.We're seeking an experienced Case Management Expert to join our marketing, distribution & partnership team. As part of this team, you'll play a vital role in advancing our movement towards...
-
Case Manager
4 weeks ago
Kuala Lumpur, Malaysia Aisling Consulting Sdn Bhd Full timeThe organization is a health and security service firm. The organization focuses on helping organisations and their people reduce exposure to, and mitigate, health, wellbeing, and security risks. Their services include providing a feed of information on world events, assistance services, health consultancy and programmes, education, advice and medical...
-
Tax Advisory Associate
2 weeks ago
Kuala Lumpur, Malaysia Cheng & Co Taxation Sdn Bhd Full time**Requirements**: Tax Advisory Associate is responsible for working on tax advisory works on business transactions that including transfer pricing analysis, tax treatment advisory and tax accounting advisory. The role of Tax Advisory Associate involves both advisory and compliance aspects. He/She must understand and keep abreast of tax legislation...
-
Non-medical Claims, Analyst
2 weeks ago
Kuala Lumpur, Malaysia AIA Group Full time**At AIA we've started an exciting movement to create a healthier, more sustainable future for everyone.** **Sound like you Then read on.** **WE ARE LOOKING FOR.....**Responsible for determining the validity and authorising settlement of insurance claims - Assess and settle insurance claims arising from policies in force - Make recommendations and guidelines...
-
Case Processing Officer
3 weeks ago
Kuala Lumpur, Malaysia International Rescue Committee Full timeThe International Rescue Committee (IRC) responds to the world’s worst humanitarian crises, helping to restore health, safety, education, economic wellbeing, and power to people devastated by conflict and disaster. Founded in 1933 at the call of Albert Einstein, the IRC is one of the world's largest international humanitarian non-governmental organizations...
-
Avp - HR Advisory
6 days ago
Kuala Lumpur, Malaysia HSBC Full time-Job description **Why join us?** The role of HR continues to develop, as HSBC drives a globally aligned model across all its functions. Banking is fiercely competitive with heavy and increasing regulation. Organizational capability, performance and talent management are under close market scrutiny. HR Advisory is part of the HR operational function and...
-
Medical Service Coordinator
7 days ago
Kuala Lumpur, Kuala Lumpur, Malaysia Persolkelly Full timeJob OverviewWe are seeking a highly motivated and experienced Medical Service Coordinator to join our team as a Medical Advisor.The successful candidate will be responsible for managing emergency medical services, providing consultation, and making recommendations for evacuations.They will work closely with the operations team to ensure high-quality medical...
-
Offshore Medical Professional
7 days ago
Kuala Lumpur, Kuala Lumpur, Malaysia Persolkelly Full timeJob DescriptionWe are seeking a highly skilled and experienced Offshore Medical Professional to join our team as a Medical Advisor.The successful candidate will be responsible for overseeing emergency medical services, providing consultation, and managing cases in a dynamic offshore environment.They will work closely with the operations team to ensure...
-
Medical Advisor
2 weeks ago
Kuala Lumpur, Malaysia Allianz Full timeMEDICAL ADVISOR We are recruiting multiple roles for our Medical Advisor team. **Role Purpose**: Allianz Care provides insurance solutions for health, life and disability on a global scale. Our focus is on earning and maintaining client loyalty by providing a global, market leading, level of service and support. We are the international health division of...