Medical Claims Executive

2 weeks ago

Cyberjaya, Selangor, Malaysia PROTECTHEALTH CORPORATION SDN. BHD. Full time 60,000 - 120,000 per year

Contract Duration: 1-year contract (with potential for renewal based on performance)

Position Overview: We are seeking an energetic and detail-oriented Medical Claims Executive to join our dynamic team at ProtectHealth Corporation Sdn. Bhd. This role is ideal for individuals with a medical or healthcare background, strong communication and presentation skills, and an extroverted personality who enjoys engaging with people and participating actively in corporate activities.

As part of our operations team, you will be responsible for ensuring accurate and timely processing of medical claims, supporting system improvements, and collaborating with internal and external stakeholders to uphold operational excellence.

What You'll Do:

  1. Review and process medical claims according to established guidelines and deadlines.
  2. Analyse and resolve routine claims issues, escalating more complex matters as needed.
  3. Communicate effectively with internal and external stakeholders about claim processing.
  4. Utilise data analysis to identify trends and suggest improvements in claim processing workflows.
  5. Support the development and implementation of efficient claims processing procedures.
  6. Collaborate with the Digital Technologies division to address system issues affecting claims.
  7. Maintain accurate records and documentation related to claims processing activities.
  8. Perform additional duties as assigned by management to support operational objectives.
  9. Get involved in company activities and events, and be ready to assist in organising or handling these activities as needed.

What We're Looking For:

  1. Bachelor's Degree in a healthcare-related field (e.g., Nursing, Medical Science, Health Administration, Biomedical Science) or equivalent qualification.
  2. 2–3 years of experience in medical claims processing, preferably in outpatient or TPA environments.
  3. Familiarity with ICD-10 and CPT coding systems is an advantage.
  4. Strong command of Microsoft Office Suite (Excel, Word, PowerPoint) and data management tools.
  5. Excellent analytical, communication, and interpersonal skills — with the confidence to conduct presentations or represent the department in discussions.
  6. Proactive, extroverted, and team-oriented individual who enjoys interacting with people and participating in company events or initiatives.
  7. High attention to detail, strong organisational skills, and the ability to work independently under minimal supervision.

Note: Only shortlisted candidates will be contacted for further selection.

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