Senior Process Executive – Cognizant Malaysia

This role is for a Senior Process Executive based in Kuala Lumpur who manages the pre-authorization process for medical treatments, procedures, or medications. The position involves ensuring approvals align with insurance policies and regulatory guidelines to support timely patient care and reimbursement.

The Senior Process Executive – Pre-Authorization role is responsible for managing the pre-authorization process involving members and medical providers. The main objective is to ensure that medical treatments, procedures, or medications that require prior approval are properly authorized in accordance with insurance policies and regulatory guidelines to facilitate timely patient care and reimbursement. This position involves reviewing and assessing pre-authorization requests for completeness and accuracy, verifying medical charges against appropriate codes, communicating authorization results to relevant parties, and escalating complex cases when necessary. The role requires effective multitasking and good time management skills, along with proficiency in Cantonese, Mandarin, and English.