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[MY] Senior/Executive, Claims (Inpatient)

Salary undisclosed

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About The Team

Doctor Anywhere's Operations team is a crucial part of the company. We ensure the day-to-day excellence of our TPA business, virtual and in-person clinical services, resolving operational issues in a timely manner and providing the best customer experience possible. We make sure that our customers remain our top priority.

About The Role

We are seeking a Senior/ Executive, Inpatient Claims who will provide accurate and timely assessment of medical claims within the required service standards and ensure that claims are paid accurately and promptly. You will have 1 to 3 years of relevant working experience in claims processing or related.

The ideal candidate will have a mindset of continuous improvement and change and will demonstrate curiosity, collaboration, and the ability to deal with ambiguity, especially in a start-up environment.

This role is based in Malaysia and reports directly to the Team Lead, Inpatient Claims.

A summary of the key responsibilities is as follows:

  • Handle the administrative functions in the Claims Department including claims registration, claims processing, sending of reminder letters and settlement letters upon claims approval.
  • Handle customer service by communicating effectively and promptly with internal and external stakeholders not limited to policyholders/claimants/doctors/nurses/insurers on claims or related work matters, and ensures customer satisfaction in the services provided.
  • Investigate, evaluate and settle claims in an efficient and timely manner, further investigating questionable claims to determine policy liability.
  • Ensure claims are assessed according to Policy’s terms & benefits and are settled within the agreed turnaround time.
  • Ensure that pending claims are followed up and managed on a timely basis.
  • Ensure strict adherence to company Standard Operating Procedures.
  • Participate in any ad-hoc project(s) or duties when required.

About You

  • Diploma/Degree in relevant discipline with 1 to 3 years of relevant working experience in claims processing.
  • Good verbal and written communications skills in English language.
  • Proficient in Microsoft Windows, Word, Outlook, Excel.
  • Insurance professional qualifications and health claims experience preferred.
  • Certification in Health Insurance (HI) is required.
  • Meticulous and able to work in a fast-paced and competitive environment.

About Doctor Anywhere

Doctor Anywhere (DA) is a regional tech-enabled, omnichannel healthcare provider delivering care to 2.5 million users across 6 countries in Southeast Asia. Founded in 2017 with a mission to make healthcare simple, accessible, and efficient for all, DA leverages technology to enable individuals towards preventive, long-term health via holistic offerings including our telehealth app, physical clinics and pharmacies, mental wellness, specialist consults, and also an online health & wellness marketplace for supplements, healthy snacks, home-based health screening and vaccinations.

DA’s goal is to build a regional digital healthcare ecosystem, advanced by the 3,000 GPs and specialists within our regional network, over 1,000 corporate organisations, and 25 regional insurers we work with. Grounded in our motto “Keep Going, Keep Growing”, our team strives towards excellence, with innovation and collaboration at our core, and values diversity in perspectives brought by every member. Join us in our mission to transform Southeast Asia’s healthcare future!

Not for you? We have other opportunities that may interest you or someone you know. Feel free to visit us at our careers page - https://doctoranywhere.com/job-listing/ for more information.

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