Junior Claims Executive

Location: OUG Parklane, Malaysia
Job Titles: Junior Claims Executive / Senior Claims Executive

Job Summary

As a Claims Executive at, you will play a vital role in processing healthcare claims accurately and efficiently. You will ensure all claims are handled in compliance with company policies and healthcare regulations, liaise with healthcare providers and insurance representatives, and provide support to clients regarding their claims inquiries.

Key Responsibilities

Junior Claims Executive:

• Review and process claims submissions accurately and promptly according to company standards.
• Verify claim details with healthcare providers, ensuring all necessary information is received.
• Ensure all claims meet regulatory and compliance requirements within the healthcare industry.
• Handle customer inquiries and provide clear and helpful information regarding claims status and procedures.
• Maintain up-to-date records of claims processed, rejected, or pending, with proper documentation.
• Assist in identifying discrepancies or irregularities in claims submissions and escalate issues as needed.

Education and Experience:

• Diploma or bachelor’s degree in healthcare, Business Administration, Finance, or related field.
• Junior Claims Executive: 1-2 years of experience in claims processing, healthcare administration, or a related field.

Skills:

• Strong attention to detail and accuracy in reviewing and processing claims.
• Excellent communication skills, with the ability to handle sensitive healthcare and financial information confidentially.
• Proficiency in MS Office Suite, especially Excel, for record-keeping and reporting.
• Analytical thinking and problem-solving abilities, especially for handling complex claims (Senior role).
• Ability to work effectively in a fast-paced environment, with strong time management skills.

Attributes:

• Customer-oriented with a professional demeanor in handling claims inquiries.
• Proactive and adaptable, with a commitment to continuous improvement.
• For Senior Claims Executive: Leadership qualities, including the ability to mentor and guide junior staff.

Benefits

• Competitive salary package with performance-based incentives.
• Comprehensive health and wellness benefits.
• Opportunities for professional growth and development.