HealthMetrics Sdn Bhd is looking for new potential candidates to fill in for Claims Assessor Specialist position. If you currently looking for new healthcare job opportunities and qualified with the job desc, feel free to apply this job.
The role of a Claims Executive is to process all the submission claims received from members, corporates or hospital within the turnaround time, to clarify information and to provide solutions and/or alternatives to members, corporates and hospital. Ensure to process the claims and GL related accurately and correctly within the targeted turnaround time, ensuring good service, correct information and good understanding is provided to the members, hospitals and corporate. Handle all document related with the claims and manage the filing system systematically.
- Provide expertise or general support by reviewing, researching, investigating, and processing claims
- Handle, process and approve claims (outpatient or inpatient) claims within the turnaround time
- Process Guarantee Letter (inpatient or outpatient) application, top-up and final Guarantee Letter when necessary
- Process requests and investigative queries for guarantee letter(s) based on patient medical report, laboratory test results, etc.
- Handle queries of claims from members, corporates and hospitals via phone and email
- Handle incoming cases/calls for hospital admission and discharge processes for patients in local
- Resolve any technical or contentious claims within the boundaries of medical knowledge and policy held
- Prepare any and all necessary documentation(s) for customers' best experience.
- Paperwork and administrative work including filling and etc
- Any ad hoc task if required
- Able to work on shift/odd hours/weekends
- Diploma/Degree holders from any medical-related fields (Medicine, Nursing, Biomedicine, Bioscience, etc) are preferred
- Minimum 2-5 years of experience
- Adaptable and able to work on own with minimal supervision
- A high level of organizational and inter-personal skills
- High attention to detail
- Able to converse, read and write in English and Bahasa Malaysia fluently
- Customer service and result oriented
healthcare system in Malaysia providing transparency to both corporates and healthcare providers. Our product was designed from ground-up with HR professionals and healthcare professionals in mind to fit the daily operations and needs of these key stakeholders.
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