Malaysian Healthcare jobs
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Health insurance claims expert(Part-time Job)
Health insurance claims expert(Part-time Job)
Job details
Full job description
About our company-Nova Technology
1. Nova technology is a leading insurance AI company and a pioneer in risk analysis solutions.
2. We have served a total of 115 insurance companies in China and continue to provide services to insurance companies in Hong Kong, the Middle East, and Southeast Asia.
3. We have completed four rounds of financing and are currently in the process of IPO on the Hong Kong Stock Exchange。
About the position
1. We need this health insurance claims expert to be proficient in the entire process of health insurance claims in Malaysia. This includes but is not limited to: review and verification of claims, covering hospitalization, surgery, outpatient services, emergency care, pharmaceuticals, physical examinations, and other related claims cases.
2. Check the policy liability, waiting period, exclusions, pre-existing conditions, limits, deductibles, coinsurance ratios, etc., and determine the scope and amount of compensation.
3. Able to review medical records, assess the necessity of medical treatment and the reasonableness of expenses, and accurately make claims decisions.
4. Be able to identify suspicious claims, fraud, and abuse risks, and initiate investigations and follow-ups when necessary.
5. Proficient in relevant Malaysian regulations and industry standards.
Pay: RM450.00 - RM900.00 per day
Work Location: Remote