Employee Benefits Consultant
2 weeks ago
Job Title
Insurance Claims Examiner
AIA Malaysia is seeking an experienced Insurance Claims Examiner to join its team in Kuala Lumpur. The ideal candidate will have a strong understanding of insurance claims processing and be able to work independently in a fast-paced environment.
Key Responsibilities
- Review medical documentation to determine the validity of loss.
- Establish covered medical insurance losses against benefits coverage and eligibility.
- Adjudicate medical claims by following organizational guidelines and within assigned authority limits.
- Evaluate and assemble additional information as required from claimant history, physician, employer, hospital details, type of medication, procedures, etc.
- Ensure confidentiality of all claims information, including claims guidelines and internal controls.
- Process claims within specified turnaround times.
- Perform other responsibilities and duties periodically assigned by supervisor to meet operational and/or other requirements.
Requirements
- Bachelor's degree or equivalent in any field of study or with relevant background.
- Minimum 3 years working experience preferably in the insurance or medical industry.
- Able to work in fast-paced environments, independently, customer-focused, result-oriented, and disciplined.
- Adaptable and able to work with minimal supervision.
- Service-oriented/customers focus with sense of urgency and practice prioritization and critical thinking in jobs.
- Demonstrate good written and oral communication skills.
- Good knowledge of using Microsoft Office and other software applications especially reporting tools.
- Able to adapt in the face of constant changes in the organization.
- Good analytical, innovative, and problem-solving skills, ability to exercise judgment and take initiative to make decisions and resolve problems.
- Excellent interpersonal, communication, and influencing skills are required with emphasis on achieving results and successful outcomes.
Seniority Level
Associate
Employment Type
Contract
Job Function
Writing/Editing, Customer Service, and Other
Industries
Insurance and Financial Services
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