Assistant Manager, Care Services

Kuala Lumpur
Tetap
Sepenuh masa

2 hari lepas

Assistant Manager, Care Services (Healthcare Services)Discover the GREAT in your career.As a LIFE company, our customers are at the heart of all that we do. Being one of Asia’s leading insurer for over a century, we have built a long-lasting legacy of trust with our customers over many generations. At the foundation of this trust is Integrity, Initiative, and Involvement – from the way we treat every customer relationship with honesty and transparency, to our proactive approach of delivering the best possible solutions in both life and general insurance.Integrity, Initiative, and Involvement is what guides us. It is what makes us do the right thing, take the lead, and choose ‘we’ over ‘me’. Our mission is to make life great for our customers because we understand what matters most to them, and we know how to help them protect it.If you are looking to grow in an enriching career filled with opportunities and potential, we are seeking an experienced professional to join our team as an Assistant Manager, Care Services (Healthcare Services).The Role:

To adjudicate, review and process guarantee letter cases.
Pre-certifies cases for issuance of guarantee letter in accordance with Company’s requirements and guidelines.
Ensure initial and final guarantee letters are issued accurately and timely.
Support Call Centre CSEs in handling technical/medical issues.
Ensure cases of fee dispute are handled and resolved within targeted TAT.
Back-up Call Centre operations.
To attend to any other tasks assigned from time to time.
To assist the Care Manager Handle/resolve issues and complaints related to guarantee letter issuance.
To assist the Care Manager in handling of cases where medical necessity is questionable and decide on the course of action in consultation with medical officer.
Takes accountability in considering business and regulatory compliance risks and takes appropriate steps to mitigate the risks.
Maintains awareness of industry trends on regulatory compliance, emerging threats and technologies in order to understand the risk and better safeguard the company.
Highlights any potential concerns /risks and proactively shares best risk management practices
Other responsibilities entailed.

Great Eastern Malaysia is committed to Equal Employment Opportunity, and all qualified applicants shall receive a fair and equal consideration for employment.Location: HQ, Kuala LumpurEntity: Great Eastern Life MalaysiaEmployment Type: PermanentTo all recruitment agencies: Great Eastern does not accept unsolicited agency resumes. Please do not forward resumes to our email or our employees. We will not be responsible for any fees related to unsolicited resumes.About Great EasternEstablished in 1908, Great Eastern places customers at the heart of everything we do. Our legacy extends beyond our products and services to our culture, which is defined by our core values and how we work. As champions of Integrity, Initiative and Involvement, our core values act as a compass, guiding and inspiring us to embrace the behaviours associated with each value, upholding our promise to our customers - to continue doing our best for them in a sustainable manner.We work collaboratively with our stakeholders to look for candidates who exhibit or have the potential to embrace our core values and associated behaviours, as these are the key traits that we expect from our employees as they develop their careers with us.We embrace inclusivity, giving all employees an equal opportunity to shine and play their role in exploring possibilities to deliver innovative insurance solutions.Since 2018, Great Eastern has been a signatory to the United Nations (UN) Principles of Sustainable Insurance. Our sustainability approach around environmental, social, and governance (ESG) considerations play a key role in every business decision we make. We are committed to being a sustainability-driven company to achieve a low-carbon economy by managing the environmental footprint of our operations and incorporating ESG considerations in our investment portfolios; improving people’s lives by actively helping customers live healthier, better and longer; and drive responsible business practices through material ESG risk management.QualificationsThe Person:

Degree in Nursing or Healthcare related discipline of State Registered Nurse or Medical Assistant with 2-3 years of experience.
5 – 8 years of clinical experience preferably with experience in A&E, ICU and OT.
Working experience in managed healthcare environment would be an asset.
Good knowledge in current healthcare delivery systems and hospital patient management and billing system would be an advantage.
Possess initiative, good interpersonal and communication skills.
Knowledge in medical terminology, contract provisions and MMA coding.
Good knowledge in current healthcare delivery systems and hospital patient management and billing system.
Have the right attitude for hard work and able to produce high quality work under pressure.
High level of integrity, takes accountability of work and good attitude over teamwork.
Takes initiative to improve current state of things and adaptable to embrace new changes.

Great Eastern

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