[MY] Executive / Senior Executive, Outpatient Claims
Doctor Anywhere
About the team
Doctor Anywhere's Operations team is a crucial part of the company. We ensure the day-to-day excellence of our TPA business, virtual and in-person clinical services, resolving operational issues in a timely manner and providing the best customer experience possible. We make sure that our customers remain our top priority.
About the role
We are seeking an Outpatient Claims Executive who will provide accurate adjudication of Health insurance claims submitted by our clients. The ideal candidate will have a mindset of continuous improvement and change and will demonstrate curiosity, collaboration and the ability to deal with ambiguity especially in a start-up environment.
This role reports directly to the Assistant Manager, Outpatient Claims.
A summary of the key responsibilities and requirements are as follows:
- Proactive management of claims, timely processing & claim administration within stipulated turnaround time (TAT)
- Adjudicate outpatient claims and decide on claim settlements and approve within authority limit
- Ensure all queries are responded to in a timely manner with continuous communication with both internal and external customers and providing the required support with the objective of providing a quality claim service experience.
- Work and maintain positive relationship with customers / corporate clients for any claims related matters
- Assist to provide necessary information and ad-hoc assignment to Manager to allow for accurate and timely submission of reports to management as well as maintaining the records, reports and claims file
- Investigate and escalate technical claim issue as and when experienced
- Other ad-hoc duties as assigned
About you
- Diploma/Degree in any discipline with minimally 3 years of assessing claims in Insurance/ Medical Assistance/ TPA experience.
- CGI and Health Insurance certification preferred but not mandatory
- Computer literate
- Self-motivated individual with a strong sense of responsibility
- Resourceful with strong problem-solving skill
- Good team player and service-oriented
About Doctor Anywhere
Doctor Anywhere (DA) is a regional tech-enabled, omnichannel healthcare provider delivering care to 2.5 million users across 6 countries in Southeast Asia. Founded in 2017 with a mission to make healthcare simple, accessible, and efficient for all, DA leverages technology to enable individuals towards preventive, long-term health via holistic offerings including our telehealth app, physical clinics and pharmacies, mental wellness, specialist consults, and also an online health & wellness marketplace for supplements, healthy snacks, home-based health screening and vaccinations.
DA’s goal is to build a regional digital healthcare ecosystem, advanced by the 3,000 GPs and specialists within our regional network, over 1,000 corporate organisations, and 25 regional insurers we work with. Grounded in our motto “Keep Going, Keep Growing”, our team strives towards excellence, with innovation and collaboration at our core, and values diversity in perspectives brought by every member. Join us in our mission to transform Southeast Asia’s healthcare future!
Not for you? We have other opportunities that may interest you or someone you know. Feel free to visit us at our careers page - https://doctoranywhere.com/job-listing/ for more information.
#LI-onsite