Posted 4 days ago
Medical Claims Specialist - Mandarin Speaker
AI Summary
Processes authorized inpatient and outpatient medical claims transactions, reviews and approves cases, responds to enquiries, and trains new joiners on claims processing rules and system navigation.
About this role
At AIA we’ve started an exciting movement to create a healthier, more sustainable future for everyone.
It’s about finding new ways to not only better people's lives, but to better the communities and environments we live in. Encompassing our ambition of helping a billion people live Healthier, Longer, Better Lives by 2030.
And to get there, we need ambitious people who believe in playing an important part in shaping that future. People seeking unmatched career and personal growth opportunities, who are driven to work with, and learn from some of the most inspiring and supportive leaders in the business.
Sound like you? Then read on.
About the Role
Process authorized inpatient & outpatient claims transactions within the required benchmarks.- Process all Inpatient, Outpatient claims and pre-approval requests received as per stipulated requirements
- Ensure meeting individual quality, turn around time and productivity benchmark
- Review/approve cases that exceeds subordinates’ authority
- Respond to email enquiries from internal and external parties
- Perform outbound call to customers when required
- Training of new joiners on claims processing rules and products knowledge including Review and Feedback for On-The-Job training cases
- Providing training in System Navigation and Processing Steps, towards certification with Claims Approval Authority, as stipulated in the Claims Approval Authority guidelines.
- Conduct regular claims review in claims performance to ensure claims principles/authorities are adhered to. Review claims decision making process to identify areas of claims risk management concerns for further improvements.
- Organize and implement team engagement activities to foster closer team spirit and create work life balance environment.
- Performs other responsibilities and duties periodically assigned by immediate manager in order to meet business requirements
Qualifications
- Educational background in Biomedical, Biotechnology, Nursing, Medicine, Chemistry or related fields
- Candidate MUST able to speak Mandarin. Ability to read and write Chinese would be an added advantage.
- Possess a minimum of 2 years experience in Medical/Life Claims processing experience
- Comfortable working onsite in Cyberjaya 4 days a week and 1 day work from home
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.
Skills
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