Role Summary
The Associate Manager, Claims-1 is responsible for reviewing, assessing, and approving shield claims while ensuring compliance with internal policies and regulatory standards. This role plays a critical part in maintaining operational efficiency and enhancing customer satisfaction through effective claims management.
Job Description
In this role, you will engage in daily activities that involve reviewing claims and interacting with various stakeholders, including clinics and hospitals. You will work in a dynamic environment that prioritizes accuracy and compliance while addressing customer inquiries and complaints.
Key Responsibilities:
- Review and assess shield claims for accuracy and compliance.
- Conduct claims investigations to gather necessary information.
- Manage service recovery processes for customer satisfaction.
- Perform medical clarifications with clinics and hospitals.
- Handle customer inquiries and resolve complaints effectively.
- Participate in special projects to improve operational efficiency.
- Ensure adherence to service turnaround times.
Job Requirements
Strong command of the English language, both spoken and written.
Deep familiarity with human anatomy, general diseases, and disease management.
Proven ability to review, assess, and approve claims accurately.
Experience in conducting medical clarifications with hospitals and clinics.
Strong customer service skills for handling inquiries and complaints.
Quick Info
Company
—
Location
Kuala Lumpur
Salary
Undisclosed
Incentive / Bonus
Performance-based bonuses and corporate incentives.
Skills Required
6 skills
Click to submit your application
Required Skills
Claims Management
Customer Service
Medical Knowledge
Investigation Skills
Communication
Problem Solving
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