Medical Claims Specialist - Mandarin Speaker

At AIA we've started an exciting movement to create a healthier, more sustainable future for everyone.

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