Claim Admin (Rotational Shift)

Role Overview

We are seeking a meticulous and service-oriented Claim Processor to manage inpatient hospitalization admissions and insurance-related processes. This role is responsible for assessing patient eligibility, reviewing policy coverage, coordinating admission requests, and delivering exceptional support throughout the admission journey.

Key Responsibilities

• Act as the primary point of contact for patients regarding inpatient hospitalization admissions and related inquiries.
• Process and coordinate admission requests accurately, ensuring compliance with insurance policies, procedures, and service standards.
• Evaluate insurance policy terms and coverage eligibility to determine admission approval and benefits entitlement.
• Review and interpret patient records, admission documentation, accounts, and supporting information to facilitate accurate and timely processing.
• Provide clear, professional, and empathetic assistance to patients by addressing admission, coverage, and claim-related inquiries.
• Investigate and resolve patient concerns efficiently, escalating complex issues or complaints to the appropriate stakeholders when necessary.
• Maintain comprehensive and accurate documentation of all admission activities, communications, and decisions.
• Collaborate with internal departments and relevant stakeholders to ensure seamless communication and coordination throughout the admission process.
• Ensure all requests, instructions, and inquiries are handled within established turnaround times and service level requirements.
• Uphold the highest standards of accuracy, confidentiality, and professionalism when managing sensitive patient and insurance information.
• Contribute to continuous process improvement initiatives to enhance operational efficiency and customer experience.

Key Competencies

• Strong attention to detail and analytical skills.
• Excellent communication and customer service abilities.
• Ability to interpret and apply insurance policy terms and conditions.
• Effective problem-solving and conflict-resolution skills.
• Strong organizational and time-management capabilities.
• Ability to work independently while collaborating effectively within a team environment.

Pay: RM2,500.00 - RM4,500.00 per month

Benefits:

• Health insurance
• Opportunities for promotion
• Professional development

Work Location: In person