Cost Containment Executive
Job Description
Job Summary
Ensuring health claims paid by ACS being cost contained and according to reasonable and customary charges with guideline from Ministry of Health as benchmark. Assist Company and department to ensure operating profit by controlling health claim's cost. Align with department target of savings per annum and best claims practices by minimizing fraud, waste and abuse in health claims handled. Provide analysis of work done as market benchmark and forthcoming claims target in years to come. Follow up on amount under clarification with hospitals and doctors involved in Allianz health claims.
Key responsibilities
- Liaise with healthcare providers and healthcare practitioners on variances or discrepancy issues which needed clarification in accordance to the 13th Schedule of fees.
- Work together with claims assessors in solving escalated cases issues.
- Conduct retrospective review on cases to monitor medical cost and length of hospitalization.
- Conduct audit on medical bills.
- Prepares reports by collecting, analyzing, and summarizing information.
- Maintain inventory and proper documentation of responses from MOH, case evidences and related information
- Diploma / Degree in Nursing, or Medical or health science related field of study.
- Years of working experience in healthcare industry ; or knowledge in medical claims
- Possess good communication skill and good command of spoken and written English and Bahasa Malaysia
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Job Detail
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Job IdJD852130
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IndustryNot mentioned
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Total Positions1
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Job Type:Full Time
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Salary:Not mentioned
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Employment StatusPermanent
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Job LocationMalaysia, Malaysia
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EducationNot mentioned