Job Description

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

General Tasks

• Process and approve assigned Conventional and Takaful Inpatient Claims/Outpatient claims/PRP claims including overseas bills and Hospital income claims within the stipulated TAT and authority limit.
• Provide Support clean team production cases in the event of backlog to ensure team TAT is met and meeting targets that align with the Dept. KPI.
• Ensure assigned PRP investigation cases are reviewed accurately and completed within the stipulated TAT and refer to in-house Dr for opinion for post underwriting cases requiring special handling.
• Review pending cases and ensure cases exceeding 90 days are closed and to send out final reminder
• To process claims according to the department’s practice and guidelines.
• To clear HAP on daily basis and staff HAP (if any junior staff assigned)
• Execute ad-hoc assignments and task assigned by team manager.
• Review and approve Inpatient Claims/Outpatient claims/PRP claims including overseas bills and Hospital income claims the granted approval authority limit.
• To make recommendation to Managers for claims exceeding approval authority, with updated EWS on the total quantum, claims details, diagnosis, procedure and the non-payable items listed accurately in EWS.
• All assessed claims to be input with benefit calculator, including for investigations and deferment claims.
• To make sure all E-payment, manual payment and journal correctly input to meet the department goal.
• Claims are not pending unnecessarily and with no follow up action within 3 working days.
• To review each assigned case as new case
• Responsible for enquiries, correspondences and claims related matters
• Responsible for managing outstanding claims within standards.
• Issuance of standard letter to agents, customers, doctors etc. for further information.

Minimum Job Requirements

• Candidate must possess at least a bachelor's degree or Diploma.
• Min 2 years of medical claim experience.
• Technical Skills: Claims assessment, medical report knowledge, Health Insurance Policy knowledge.
• Industry: 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.

Job Requirements