Job Description

Job Title: Senior Processor Executive / Team Lead (Insurance - Provider Relations) - Cantonese Location: Malaysia Language Requirement: Must have proficiency in Cantonese (Verbal and written) Summary: Senior Processor Executive: Handle enquiries from network providers including but not limited to card acceptance / PA / outstanding claim status / contractual & fee review Provide administrative support including but not limited to report generation / system updates & maintenance / claim status checking / calls to network providers as ad hoc request / maintenance of network summaries / voucher request handling Provide administrative support including but not limited to report generation / system updates & maintenance / follow-up with network providers via email / communication with Claims for processing Team Lead: Oversee and supervise subordinates in their day-to-day activities, to ensure contract compliance activities are carried out. Oversee and supervise subordinates on admin support and network healthcare provider data maintenance in PCMS system, to ensure contract compliance activities are carried out. Job Responsibilities and Expectations · Handle phone call and email enquiries from our network provider regarding the medical cards, pre-authorization, referrals · Handle enquiries related to contract renewal, fee review, portal access and movement notice · Provide information on pre-authorization status, Guarantee of Payment Letter and claims · Update and maintain accurate records of all inquiries and provider list · Generate different reports and network summaries on regular and ad hoc basis. · Handle movement notices and update internal systems. · Create and maintain provider records, provider related codes and contract details in internal systems. · Support onboarding of new providers. · Send notification email to internal parties on ""Large Hospital Claim"" cases. · Handle contract renewals and maintain system reference data. · Check claims status upon receiving enquiries from network providers. · Ensure all data entries and system updates are accurate and completed on time. · Make calls to network providers upon ad hoc request. Team Lead: · Oversee and supervise subordinates on day-to-day activities. Manage the Team to perform the duties accurately and efficiently. · Monitor performance of the team to ensure delivery of agreed KPI. · Provide regular training to staff and new joiners. · Maintain standard operating procedures in the team up-to-date and ensure the team’s compliance to the agreed processes. · Conduct regular communications and provide coordination with Team on the services. Establish internal escalation workflow. · Make clear and justifiable decision and escalate to HK Team when (and only when) necessary. · Prepare performance reporting for review on regular basis. Handle ad hoc tasks assigned by Team. Desired Experience: · With 1 year of experience in provider relations or health insurance · Good communication and negotiation skills. Good analytical and problem solving skills · Detail-minded and willing to accept new challenges Team Lead: · With at least 4 years of solid experience at Team lead level in provider relations or health insurance · Strong sense of continuous improvement and desire to deliver quality outputs; strive to over-deliver on SLAs to improve and enhance work efficiency and quality · Exceptional communication and negotiation skills. · Strong analytical, problem solving and root cause identification skills and strong attention to detail About Cognizant: Cognizant (Nasdaq: CTSH) engineers modern businesses. We help our clients modernize technology, reimagine processes and transform experiences so they can stay ahead in our fast-changing world. Together, we're improving everyday life. See how at www.cognizant.com or @cognizant. #LI-CTSAPAC The Cognizant community: We are a high caliber team who appreciate and support one another. Our people uphold an energetic, collaborative and inclusive workplace where everyone can thrive. Cognizant is a global community with more than 300,000 associates around the world. We don’t just dream of a better way – we make it happen. We take care of our people, clients, company, communities and climate by doing what’s right. We foster an innovative environment where you can build the career path that’s right for you. About us: Cognizant is one of the world's leading professional services companies, transforming clients' business, operating, and technology models for the digital era. Our unique industry-based, consultative approach helps clients envision, build, and run more innovative and efficient businesses. Headquartered in the U.S., Cognizant (a member of the NASDAQ-100 and one of Forbes World’s Best Employers 2024) is consistently listed among the most admired companies in the world. Learn how Cognizant helps clients lead with digital at www.cognizant.com Cognizant is an equal opportunity employer. Your application and candidacy will not be considered based on race, color, sex, religion, creed, sexual orientation, gender identity, national origin, disability, genetic information, pregnancy, veteran status or any other characteristic protected by federal, state or local laws. Disclaimer: Compensation information is accurate as of the date of this posting. Cognizant reserves the right to modify this information at any time, subject to applicable law. Applicants may be required to attend interviews in person or by video conference. In addition, candidates may be required to present their current state or government issued ID during each interview.

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