Job Description

We are seeking an experienced

Junior Executive - Panel Unit (Clinic)

to oversee claims handling and coordination for

Third Party Administrators (TPA)

and

Direct Arrangement (DA)

related to our panel clinics. The role involves ensuring accurate claim processing, smooth clinic operations, and maintaining strong relationships with both internal teams and external partners.

Key Responsibilities

Manage and process panel clinic claims for TPA & DA in compliance with company policies and SLAs. Verify claim documents, confirm patient eligibility, and process payments accurately. Act as the main liaison between panel clinics, TPA, DA partners, and internal departments. Maintain and update panel clinic agreements, fee schedules, and service rates. Coordinate with clinics to resolve claim disputes or billing issues promptly. Monitor clinic claims turnaround times to ensure efficient processing. Prepare and present regular clinic claims reports to management. Support clinic-related audits and ensure compliance with all regulatory and operational standards.

Requirements

Diploma in Healthcare Management, Business Administration, or related field. At least 3 years' experience in healthcare claims, panel clinic administration, or related role. Familiarity with TPA & DA claim processes and clinic operations is an advantage. Strong organizational and analytical skills. Proficiency in MS Office and claim management systems. Excellent communication and relationship management skills.
Job Types: Full-time, Permanent

Pay: RM1,800.00 - RM2,000.00 per month

Benefits:

Maternity leave Opportunities for promotion Parental leave Professional development
Application Question(s):

Availability Expected Salary
Work Location: In person