Individual Benefit Cashless Claim, Analyst
AIA Group · Kuala Lumpur
Start building a career with purpose.
At AIA, your perspective, curiosity and ideas can contribute to our Purpose of helping millions of people live Healthier, Longer, Better Lives. Across our diverse markets, you will learn through meaningful work, collaborate with experienced colleagues and build practical skills as you turn fresh ideas into positive outcomes and a more sustainable future for our customers and communities.
Join us to explore new possibilities, grow through real experiences and start making an impact across Asia.
About the Role
Ensure claims are adjudicated accurately and in a timely manner by establishing the validity of loss through assessment of medical documentation & assembling additional information as required.
Roles & Responsibilities:
Ensure completeness of Claims / Guarantee Letter Pre-certify documents in compliance to Company’s requirements and guidelines
Adjudicate medical claims by following the organization guidelines & within the assigned authority limit.
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).
Ensure confidentiality of all claims information, inclusive of claims guidelines and internal controls.
To identify Process improvement ideas & initiatives leading to greater operations effectiveness and efficiency.
Ensure claims are processed within the specified turnaround time
To performs other responsibilities and duties periodically assigned by supervisor to meet operational and/or other requirements.
Minimum Job Requirements:
- Bachelor’s degree or equivalent, in any field of study or with relevant background.
- Minimum of 5 years working experience preferably in the insurance or medical industry.
- Candidate with medical insurance/nursing/medical science/hospital background will be added advantage.
- Able to work in fast paced environment, independent, customer focused, result oriented & disciplined.
- Adaptable and able to work on own with minimal supervision.
- Ability to multi-task, plan effectively and meet deadlines.
- Service oriented/customers focus with sense of urgency and practice prioritization and critical thinking in jobs.
- Demonstrate good written and oral communication skills.
- Good knowledge of using Microsoft Office and others software applications especially reporting tools.
- Able to adapt in the face of constant changes in the organization.
- Good analytical, innovative and good in problem solving skill, ability to exercise judgment and take initiative to make decision and resolve problem(s).
- Excellent interpersonal, communication and influencing skills are required with emphasis on achieving results and successful outcomes.
- Able to work on rotating shifts.
- Contract position available.
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.