Senior Medical Claims Executive (Healthcare Industry)
Location: OUG Parklane, Malaysia
Job Titles: Senior Claims Executive
Job Summary
The Senior Claims Executive will additionally handle complex cases, mentor junior staff, and support claims process improvements.
Key Responsibilities
- Handle complex or high-value claims, providing in-depth analysis and investigation as necessary.
- Review and approve claims processed by junior staff, ensuring accuracy and adherence to company policies.
- Mentor and train junior Claims Executives on claims handling procedures and best practices.
- Collaborate with management to implement process improvements and develop streamlined claims workflows.
- Conduct periodic audits of claims to ensure compliance with industry regulations and internal standards.
- Act as a primary point of contact for escalated claims issues, working closely with healthcare providers, insurers, and clients to resolve disputes.
Key Requirements
Education and Experience:
- Diploma or bachelor’s degree in healthcare, Business Administration, Finance, or related field.
- Senior Claims Executive: 3-5 years of experience in healthcare claims processing, with exposure to complex claims management and team leadership.
- Familiarity with healthcare claims systems and regulations is preferred.
Skills:
- Strong attention to detail and accuracy in reviewing and processing claims.
- Excellent communication skills, with the ability to handle sensitive healthcare and financial information confidentially.
- Proficiency in MS Office Suite, especially Excel, for record-keeping and reporting.
- Analytical thinking and problem-solving abilities, especially for handling complex claims (Senior role).
- Ability to work effectively in a fast-paced environment, with strong time management skills.
Attributes:
- Customer-oriented with a professional demeanor in handling claims inquiries.
- Proactive and adaptable, with a commitment to continuous improvement.
- Leadership qualities, including the ability to mentor and guide junior staff.
Benefits
- Competitive salary package with performance-based incentives.
- Comprehensive health and wellness benefits.
- Opportunities for professional growth and development.
- Supportive work environment focused on innovation in healthcare services.
- Locations
- Selangor
- Job location
- Selangor
Workplace & Culture at Sperton
At Sperton, we believe that great results come from great people.
Our culture is built on trust, collaboration, and a shared passion for delivering quality in everything we do.
We are a Norwegian-owned international company with colleagues across Europe, Asia, and the USA, working together seamlessly across time zones and cultures. Our teams are diverse, yet united by the same goal — to connect people and companies in meaningful ways.
We value openness, initiative, and continuous learning. Everyone at Sperton is encouraged to take ownership, share ideas, and challenge existing ways of working to make our solutions even better.
Even though we operate globally, our approach is personal. We take pride in creating a supportive and inclusive environment where people feel heard, respected, and motivated to grow — both professionally and personally.
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