Bring your career aspirations to life with AIA!

Responsible to process, approve and ensure payment is paid accurately and timely within the turnaround time set and continuous improvement of work process to achieve operational excellence contributing to division’s KPI.

Roles and Responsibilities:

• Ensure completeness of claims documents as per internal guideline.

• Establish covered medical insurance losses against benefits coverage and eligibility.

• Establish proof of loss by studying medical documentation; assembling additional information as required from other sources, such as claimant history, physician, employer, hospital details, type of medication, procedures & etc. Escalate questionable claims to the direct supervisor / medical advisory officers (if required).

• Resolve medical claims by approving or denying documentation; calculating benefit due; initiating payment or denial letter.

• Ensure claims are processed within the specified turnaround time

• Ensure confidentiality of all claims information, inclusive of claims guidelines and internal controls.

• Maintain quality customer services by following customer service practices; responding to customer inquiries.

• Accomplish organization goals by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to the organization.

• Carry out studies to identify process improvements ways to reduce waste and maximize resources.

• Conduct regular quality monitoring to identify customer requirements and ensure they are being met by established quality standards.

• Prepare and present reports to update senior management on quality activities.

• Maintain proper records of quality monitoring, procedures and standards.

Minimum Job Requirements:

• Education: Bachelor's Degree in any field of study or with relevant background

• Years of Experience: Minimum 3 years of experience

• Technical Skills: Claims assessment, Medical insurance, Medical Science

• Industry: Health Insurance, Third-Party Administrator, Hospitals, Clinics, Medical Labs

• Language: English and Bahasa Malaysia

Build a career with us as we help our customers and the community live healthier, longer, better lives.

You must provide all requested information, including Personal Data, to be considered for this career opportunity. Failure to provide such information may influence the processing and outcome of your application. You are responsible for ensuring that the information you submit is accurate and up-to-date.