Training, Case Management & Ops Sop Governance, Analyst
AIA Australia
Kuala Lumpur, Malaysia
Fraud, waste and abuse identification
Medical claims adjudication
Process improvement strategies
Responsible for determining operational excellence and customer satisfaction by empowering assessors through continuous training, reducing operational costs, ensuring consistent in validity and authorizing settlement of medical health
Job Summary
Responsible for determining operational excellence and customer satisfaction by empowering assessors through continuous training, reducing operational costs, ensuring consistent in validity and authorizing settlement of medical health.
Responsible for handling complex policy cases which require special investigative skills or significant involvement and collaboration from different stakeholders to follow through together with MOH directives while fostering a culture of compliance, efficiency, and integrity.
To conduct robust medical training aligned with technical aspects of claims processing.
Matching Summary
Responsible for determining operational excellence and customer satisfaction by empowering assessors through continuous training, reducing operational costs, ensuring consistent in validity and authorizing settlement of medical health.
Skills & Requirements
Must-have
Fraud, Waste and Abuse identification
Medical claims adjudication
Process improvement strategies
Stakeholder collaboration
Medical Advisory for claims
Nice-to-have
Healthier, Longer, Better Lives ambition
Inspiring and supportive leaders
Culture of compliance and integrity
Continuous learning opportunities
Key Requirements
Bachelor’s degree in health sciences or equivalent
Minimum 5 years experience
Industry-related medical or healthcare certification
Strong analytical and audit skills
Knowledge of insurance claims adjudication and MOH guidelines