AIA Group

Pan-Asian life insurance provider

Individual Benefit Cashless Claim Analyst

Claims AdjudicationConfirmed live in the last 24 hours

Full-timeKuala Lumpur, Federal Territory of Kuala Lumpur, MalaysiaNo salary listedIn-person

About the Job

Requirements

A bachelor's degree or equivalent in any field of study, or relevant background, is required.
A minimum of 5 years of working experience is required, preferably in the insurance or medical industry.
A medical insurance, nursing, medical science, or hospital background is an advantage.
Ability to work in a fast-paced environment independently, with customer focus, results orientation, and discipline.
Ability to adapt and work independently with minimal supervision.
Ability to multitask, plan effectively, and meet deadlines.
Service orientation, customer focus, urgency, prioritization, and critical thinking are required.
Good written and oral communication skills are required.
Good knowledge of Microsoft Office and other software applications, especially reporting tools, is required.
Ability to adapt to constant organizational changes is required.
Analytical, innovative, and problem-solving skills, with judgment and initiative to make decisions and resolve problems, are required.
Interpersonal, communication, and influencing skills focused on achieving results and successful outcomes are required.
Ability to work rotating shifts is required.

Responsibilities

Ensure claims and guarantee letter pre-certification documents are complete and comply with company requirements and guidelines.
Adjudicate medical claims according to organizational guidelines and within assigned authority limits.
Establish covered medical insurance losses against benefit coverage and eligibility.
Establish proof of loss by reviewing medical documentation and obtaining additional information as needed from sources such as claimant history, physicians, employers, hospitals, medication types, and procedures; escalate questionable claims to a direct supervisor or medical advisory officers when required.
Maintain the confidentiality of all claims information, including claims guidelines and internal controls.
Identify process improvement ideas and initiatives that increase operational effectiveness and efficiency.
Process claims within the specified turnaround time.
Perform other responsibilities and duties assigned periodically by a supervisor to meet operational or other requirements.

Start building a career with purpose.

At AIA, your perspective, curiosity and ideas can contribute to our Purpose of helping millions of people live Healthier, Longer, Better Lives. Across our diverse markets, you will learn through meaningful work, collaborate with experienced colleagues and build practical skills as you turn fresh ideas into positive outcomes and a more sustainable future for our customers and communities.

Join us to explore new possibilities, grow through real experiences and start making an impact across Asia.

About the Role

Ensure claims are adjudicated accurately and in a timely manner by establishing the validity of loss through assessment of medical documentation & assembling additional information as required.

Roles & Responsibilities:

Ensure completeness ofClaims/ Guarantee Letter Pre-certifydocumentsin compliance to Company’s requirements and guidelines

Adjudicatemedical claims byfollowing theorganizationguidelines & within the assignedauthoritylimit.

Establish covered medical insurance losses againstbenefitscoverage and eligibility.

Establish proof of loss by studying medical documentation; assemblingadditionalinformation asrequiredfrom other sources, such as claimant history, physician, employer, hospital details, type of medication, procedures & etc. Escalate questionable claims to the direct supervisor / medical advisory officers (ifrequired).

Ensure confidentiality of all claims information,inclusive ofclaims guidelines and internal controls.

ToidentifyProcess improvementideas &initiativesleading to greater operations effectiveness and efficiency.

Ensure claims are processed within the specified turnaround time

Toperformsother responsibilities and duties periodically assigned by supervisor to meet operational and/or other requirements.

Minimum Job Requirements:

Bachelor’s degree or equivalent, in any field of study or with relevant background.
Minimum of 5 years working experience preferably in the insurance or medical industry.
Candidate with medical insurance/nursing/medical science/hospital background will be added advantage.
Able to work in fast paced environment, independent, customer focused, result oriented & disciplined.
Adaptable and able to work on own with minimal supervision.
Ability to multi-task, plan effectively and meet deadlines.
Service oriented/customers focus with sense of urgency and practice prioritization and critical thinking in jobs.
Demonstrate good written and oral communication skills.
Good knowledge of using Microsoft Office and others software applications especially reporting tools.
Able to adapt in the face of constant changes in the organization.
Good analytical, innovative and good in problem solving skill, ability to exercise judgment and take initiative to make decision and resolve problem(s).
Excellent interpersonal, communication and influencing skills are required with emphasis on achieving results and successful outcomes.
Able to work on rotating shifts.
Contract position available.

Build a career with us as we help our customers and the community live Healthier, Longer, Better Lives.

You must provide all requested information, including Personal Data, to be considered for this career opportunity. Failure to provide such information may influence the processing and outcome of your application. You are responsible for ensuring that the information you submit is accurate and up-to-date.

About the Company

AIA Group

Pan-Asian life insurance provider

AIA Group provides life insurance and related financial protection across Asia. It sells life insurance, protection, and long-term savings products to individuals and groups, paying benefits and claims when needed. It differentiates itself with a pan-Asian footprint across 18 markets, long-standing customer and agent relationships, and a strong focus on environmental, social, and governance practices. Its goal is to be a leader in ESG while helping millions live Healthier, Longer, Better Lives and creating long-term value for stakeholders.

Company size: 10,001+
Company stage: Not listed
Total funding: $618.7M
Headquarters: Central and Western District, Hong Kong
Founded: Not listed

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