Job Description

• To perform basic reports analysis, claims form examination and provide recommendation on case for admission within Authority.
• Register cases into the Medical system for admission accurately and in a timely manner. This shall include the verification of customers.
• To work and coordinate with the Data department, in the event of, any failure of data verification or any data inaccuracies detected. This shall include working and coordinating with clients on the subject of data verification

or data inaccuracies. * To ensure proper and complete instructions on claim eligibility are provided on claims assessment sheet for accurate and timely settlement of the claim. This shall include issue of any initial and/or final LG/NG/Deferments/Medical Enquiries following the instructions of the appointed immediate supervisor/ Healthcare Operations Seniors.

• To prepare all documentations which are relevant to the case and, to escalate to the immediate supervisor for approvals.
• Register cases into the Medical system for discharge accurately and in a timely manner.
• To process bills by allocating charges in accordance to the benefits of the customers policy which are stipulated in the worksheet provided. To perform basic cost containment when adjudicating claims.
• Close cases with relevant documents and information in a timely manner within the agreed SLA.
• To carry out after- hours (8pm to 8am) assigned works. This shall include the need for verification of customer and benefits, Issuance of outpatient LG and respond to phone calls.
• To promote the best image of the company through the professional claims handling skills and strict adherence to company standards and procedures.
• Act as the first point of contact for service providers on the status of a case.

• Respond to phone calls, e-mails and faxes within agreed client SLA and offer appropriate solutions and information

Job Responsibilities

• Diploma/Degree in Science/Nursing/ Medical bioscience or related field.
• Experience in medical claims management, but fresh graduates are welcomed.

• Proficient in both spoken and written English and Bahasa Malaysia.
• Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint).

• Orientation, interpersonal and communication skills.

Remuneration

• Basic Salary: RM2,500 - RM3,500
• Shift Allowance: RM1,000

Consultant In Charge

• Ashley Yuen | ashley.yuen@hunters-in.com | 017 819 9737
• Kelvyn Chan | kelvyn.chan@hunters-in.com | 011 5559 2198