Role Summary
The Employee Benefits Claims Management Analyst is responsible for determining the validity and authorizing the settlement of group health insurance claims. This role operates in a fast-paced environment, focusing on compliance and process improvements while maintaining confidentiality.
Job Description
As an Analyst in Employee Benefits Claims Management, you will engage in daily adjudication of medical claims and establish coverage based on medical documentation. You will ensure compliance with company guidelines while identifying opportunities for process enhancements.
Key Responsibilities:
- Adjudicate medical claims within assigned limits.
- Establish coverage based on medical documentation.
- Ensure compliance with company guidelines.
- Identify process improvements.
- Maintain strict confidentiality.
- Meet specified turnaround times.
- Work in a fast-paced operational setting.
Job Requirements
Bachelor’s degree in any field of study; medical or nursing background is an advantage.
Minimum of 5 years of working experience, preferably in the insurance or medical industry.
Strong analytical and problem-solving skills.
Excellent interpersonal and communication skills.
Proficient in Microsoft Office and various reporting tool applications.
Ability to work on rotating shifts.
Quick Info
Company
—
Location
Kuala Lumpur
Salary
Undisclosed
Incentive / Bonus
Performance-based bonuses
Skills Required
6 skills
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Required Skills
Analytical Skills
Problem-Solving
Communication
Interpersonal Skills
Microsoft Office
Reporting Tools
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