Role Summary
The Employee Benefits Claims Management Analyst is responsible for adjudicating group health insurance claims, ensuring compliance with company guidelines, and maintaining operational efficiency within a fast-paced environment.
Job Description
As an Analyst in Employee Benefits Claims Management, you will be responsible for determining the validity and authorizing the settlement of group health insurance claims. Key duties include adjudicating medical claims within assigned limits, establishing coverage based on medical documentation, and ensuring compliance with company guidelines. You will also identify process improvements and maintain strict confidentiality while meeting specified turnaround times 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 with the ability to exercise sound judgment.
Excellent interpersonal and communication skills with an emphasis on achieving results.
Proficient in Microsoft Office and various reporting tool applications.
Ability to work on rotating shifts and manage multiple tasks under minimal supervision.
Quick Info
Company
—
Location
Kuala Lumpur
Salary
Undisclosed
Skills Required
8 skills
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Required Skills
Claims Management
Medical Adjudication
Insurance Operations
Data Reporting
Microsoft Office
Analytical Thinking
Problem Solving
Communication Skills
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