Claims Investigation Executive

Job description

Are you looking for something different instead of more of the same?

In your new role, you will process health claims while ensuring that our department’s strategic initiatives support the company’s mission and business goals, with a focus on risk mitigation and fraud prevention.

 

You'll be responsible for:

·  Processing and assessing health claims, particularly in investigation cases.
·  Identifying and flagging potential abuses or suspected fraud during claim assessments.
·  Assessing health claims for potential non-disclosures or pre-existing conditions, and developing strategies to gather evidence.
·  Meeting targets for cost avoidance.
·  Reviewing and resolving outstanding investigation claims.
·  Liaising with customers, agents, and doctors to facilitate claim settlements.
·  Ensuring claims are processed within the department’s specified turnaround time.
·  Drafting and sending correspondence independently.

 

Important for your success:

·  Graduate in bio-medical science or any science related studies is an added advantage.
·  2 years in health claims is an added advantage 
·  Knowledge in medical terms/medical related studies is an added advantage
·  Experience in claims investigation
·  Good communication skills in both written and verbal
·  Ability to think out of box

 

55728 | Customer Services & Claims | Professional | Allianz Malaysia | Full-Time | Permanent

 

 

Allianz Group is one of the most trusted insurance and asset management companies in the world. Caring for our employees, their ambitions, dreams and challenges, is what makes us a unique employer. Together we can build an environment where everyone feels empowered and has the confidence to explore, to grow and to shape a better future for our customers and the world around us. 
We at Allianz believe in a diverse and inclusive workforce and are proud to be an equal opportunity employer. We encourage you to bring your whole self to work, no matter where you are from, what you look like, who you love or what you believe in.
We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, disability or sexual orientation.
Great to have you on board. Let's care for tomorrow.