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Medical Claims Examiner

3 weeks ago

Kuala Lumpur, Kuala Lumpur, Malaysia Cigna Health and Life Insurance Company Full time
Job Description

Critical analysis and processing of claims for medical expenses within a fixed turnaround time is the core responsibility of this role.

  • A critical thinker will assess and process claims for medical expenses, prioritizing confidentiality and accuracy.
  • Data entry into system applications requires precision and attention to detail.
  • An analytical mindset is essential for managing costs and optimizing existing workflows.
  • Effective workload management includes monitoring chronology and processing time, with suitable actions taken as needed.
  • Efficient claim processing involves informing Team Leaders about unclear claims and identifying opportunities for process optimization.
  • Maintaining high-quality claims handling, accurate reimbursements, and fast transactions are key performance indicators.
  • Clear communication about dossiers to internal stakeholders is crucial.
  • Irregularities in procedures must be tracked and reported to Team Leaders.
About The Role

This position requires a Bachelor's degree or equivalent experience, with active knowledge of English and passive knowledge of another language.

  • Education Level: A bachelor's degree or similar level of expertise.
  • Specific Knowledge:
  • Active knowledge of English and passive knowledge of another language.
  • Medical terminology and reference works are essential.

Skills and Qualifications

  • Takes informed decisions based on available information.
  • Comfortable working with numbers and data.
  • Accurate data entry and minimal errors are expected.
  • Attention to procedure, agreements, and document flows is necessary.
  • Finds a balance between quality and quantity in work output.
  • Collaborative team player with excellent communication skills.
  • Promptly learns new software applications and company systems.
  • Discreet handling of confidential information is required.