Medical Claims Team Leader - Malaysia

Job Level:  Professional
Location: 

KUALA LUMPUR, Federal Territory of Kuala Lumpur, MY

Area of Expertise:  Customer Services & Claims
Unit:  Allianz Partners
Employing Entity:  AWP SERVICES SDN BHD
Job Type:  Full-Time
Remote Job:  Hybrid working
Employment Type:  Permanent
ID:  74598
Position Cluster:  Non-Executive

Our employees play an integral part in our success as a business. We appreciate that each of our employees are unique and have unique needs, ambitions and we enjoy being a part of their journey.We are there to empower and encourage you with your personal and professional development ensuring that you take control by offering a large variety of course and target development programs. All that in a global environment where international mobility and career progression are encouraged. Caring for your health and wellbeing is key priority for us. This is why we build work well programs to providing you with peace of mind and give the flexibility in planning and arranging for better work life balance.

 

JOB DETAILS / ROLE PURPOSE


Responsible for the management of claims function in a timely and cost effective manner through the application of your skills, background and knowledge


KEY RESPONSIBILITIES


Management of the Claims Function
•Manage Service Level Agreements (SLA) of our partners/ internal teams and lead the team to either met or exceed the agreed SLA
•Identify the priorities in claims function to increase the efficiency in claim processes and improve in customer satisfaction;
•Manage the performance and quality of the Claims through OFR and CFR review collaborated with Quality Assurance Team.
•Acts as the primary technical referral point and/or operation escalations for team members
•Provide approval within the claims authority limit
•Manage customer feedback, inquiries and complaints promptly and effectively within designated timelines whilst providing a feasible resolution through established departmental processes and procedures
•Execution of training plan when required
•Participate in team projects and/or ad-hoc tasks as assigned
•Promote positive teamwork and collaboration in assuming the responsibilities of other team members as and when required.
•Being involved in Partner Relationships meetings; and
•Representing Allianz Partners as a Senior Operations Leader Operations – Strategy Ownership
•Owning and managing the Claims Operation Strategy Plan actions; and
•Being part of the Operations Senior Leadership team to drive company’s strateg


PROFILE KEY REQUIREMENT


• Minimum Diploma or Degree in medical.
• Minimum 3 years of relevant work experience in clinical practice or medical claims department.
• At least 2 years relevant experience in a team leader or supervisory role.
• Strong understanding of medical terminology, diagnoses, and treatment protocols.
• Those with insurance, medical or travel backgrounds will have an added advantage.
• Proven written and verbal communication skills in English.
• Proficient in all Microsoft Office Applications
• Able to make decisions swiftly and put decisions into practical use.
• Works within a team environment, treating all team members with care and respect and assisting other team members as needed

Our employees play an integral part in our success as a business. We appreciate that each of our employees are unique and have unique needs, ambitions and we enjoy being a part of their journey.We are there to empower and encourage you with your personal and professional development ensuring that you take control by offering a large variety of course and target development programs. All that in a global environment where international mobility and career progression are encouraged. Caring for your health and wellbeing is key priority for us. This is why we build work well programs to providing you with peace of mind and give the flexibility in planning and arranging for better work life balance.