Deskripsi Pekerjaan
Are you detail-oriented with a passion for the healthcare industry? Integrated Health Plans is seeking a dedicated Claims Officer / Executive to join our dynamic team in Bayan Lepas, Penang. In this pivotal role, you will be responsible for the review, assessment, and approval of medical claims, ensuring accuracy and adherence to company policies and regulatory standards. We pride ourselves on delivering exceptional service, and your role will be crucial in maintaining our reputation for reliability and efficiency.
You will handle a high volume of medical claims, verifying that all supporting documentation is complete and accurate. We are looking for a proactive professional who can work efficiently within the agreed targeted service turnaround time, minimizing delays for our policyholders. If you possess a strong analytical mind and a commitment to excellence, we want to hear from you.
Tanggung Jawab
- Review and assess medical claims to ensure strict compliance with policy terms and conditions.
- Verify the accuracy and completeness of all supporting documentation before final approval.
- Process claims within the agreed service turnaround time targets to ensure high customer satisfaction.
- Handle and resolve inquiries from policyholders and healthcare providers regarding claim status.
- Ensure accurate data entry and maintenance of claims records in the system.
- Collaborate with internal teams to improve claims processing workflows and identify areas for optimization.
- Stay updated on changes in healthcare regulations and insurance policies to ensure ongoing compliance.
Kualifikasi
- Diploma or Degree in any field; a degree in Health Sciences or Business Administration is preferred.
- Minimum of 1-2 years of relevant experience in claims processing, insurance administration, or healthcare support.
- Strong attention to detail with the proven ability to identify discrepancies in documentation.
- Excellent verbal and written communication skills in English and Malay.
- Proficiency in Microsoft Office applications (Word, Excel, Outlook) and data management.
- Familiarity with claims management software or ERP systems is an advantage.
- Ability to work independently and meet tight deadlines in a fast-paced environment.