Medical Advisory, Case

2 days 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 performing pre-certification; prospective, concurrent, and retrospective review of hospitalization; and to ensure cost containment measures are carried out without compromising on the care quality and service standards.
- To support a team lead to coordinate a pre-certification of Supplementary GLs (Additional procedure/ Additional Top Up Letters, LOS monitoring), case management in the issuance of guarantee letter in compliance to Company’s requirements and guidelines.
- To ensure that service standards and efficiency benchmark for issuance of supplementary guarantee letters are met.
- To support Health Claims team in the supplementary guarantee letter issuance process to ensure TAT service expectations are met.
- To communicate and ensure all relevant information on the supplementary GL and cost containment measures are cascaded to all relevant units in AIA.
- To handle issues and complaints related to supplementary guarantee letter issuance in the absence of the person in charge of complaint handlings.
- To assist team leader in mentoring and training new staff or junior staff in the Medical, Fraud and Knowledge Management unit.
- Performs other responsibilities and duties periodically assigned by supervisor in order to meet operational and/or other requirements.
- To participate and represent MFK in all process improvement initiatives.
- Build a career with us as we help our customers and the community live Healthier, Longer, Better Lives._

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