At AIA we've started an exciting movement to create a healthier, more sustainable future for everyone.
Sound like you Then read on.
About the Role
Responsible for providing technical medical expertise for decisions and resolution of customer enquiries and claims and managing healthcare related services provided to policy holders.
Main responsibilities:
- Ensure claim process at TPA have good quality and valid as our policy provision
- Analyze TPA cashless claim
- Secondary layer review case amount 20 million before creating CDV
- Monitoring cashless performance at TPA by creating solution to minimize repetitive error or any delayed process
- Minimize complaint and increase customer satisfaction
- Cooperate with Underwriting Dept related cases with PEC/NDC that's found at TPA claim process
- Respond any enquiry from provider related claim payment by AIA
Ad hoc:
- Report NDC finding for re-underwriting review
- Meeting with customer
Job Requirements:
- Bachelor's degree with medical doctor (must)
- Minimum 5 years of relevant experience in life or health insurance industry
- Have a good knowledge in system, claim process, insurance principal and AIA policy provision
- Able to work in a fast-paced environment
- Good communication skill english written and verbal skill is preferable
- Good leadership and decision-making skill
