Role Summary
The Claims Administrator is responsible for reviewing, assessing, and approving group insurance claims. This role plays a critical part in ensuring compliance with internal policies and regulatory standards while managing interactions with various stakeholders.
Job Description
As a Claims Administrator, you will engage in daily tasks that involve adjudicating health and medical claims within designated service turnaround times. You will work in a collaborative environment, coordinating with underwriters and external stakeholders to enhance workflow efficiency.
Key Responsibilities:
- Review and assess group insurance claims for approval.
- Adjudicate health and medical claims in compliance with policies.
- Manage claim investigations and coordinate with external stakeholders.
- Identify and implement workflow improvements.
- Handle service recovery and respond to enquiries.
- Maintain accurate documentation throughout the claims process.
- Ensure all decisions are prudent and equitable.
Job Requirements
Diploma or Degree in any relevant field.
2 to 3 years of working experience in medical claims processing.
Strong command of spoken and written English.
Familiarity with human anatomy and general diseases.
Knowledge of disease management and medical terminology.
Ability to work with external parties such as regulators and medical institutions.
Detail-oriented with strong analytical skills for claim adjudication.
Quick Info
Company
—
Location
Kuala Lumpur
Salary
Undisclosed
Incentive / Bonus
Not specified
Skills Required
6 skills
Click to submit your application
Required Skills
Claims Processing
Analytical Skills
Communication
Attention To Detail
Regulatory Compliance
Stakeholder Management
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