MSH Sea Hiring! Full Time GL Adjudicator & Insured Relation Executive in WP Kuala Lumpur, Earn up to MYR 3,500 - Ricebowl

Qualifications & Experience

We seek candidates with the following profile:

• Diploma or bachelor’s degree in medical sciences, Languages, Office Administration, or a related field.

• Prior experience or internships in: Insurance industry, Third Party Administration (TPA), or call centers (preferred but not mandatory).

• Customer service roles in fast-paced, high-call-volume environments.

• Medically related establishments (preferred but not mandatory).

• Fluency in English (spoken and written) is mandatory, with strong communication skills and the ability to handle complex inquiries.

• Additional language skills (spoken and written) - Fluent in Mandarin, French, Japanese, Thai, Korean, Spanish are a plus and may result in higher compensation.

• Proficiency in Microsoft Office, email management, and general IT literacy.
  
  

Position – GL Adjudicator & Insured Relation Executive

Role & Responsibilities

Deliver high-quality customer service to insured members by managing incoming and outgoing calls efficiently, in line with company standards and service objectives.

Handle a high volume of calls while maintaining accuracy, professionalism, and clear communication at all times.

Process simple adjustment claims (reimbursement requests) accurately and within defined SLAs.

Respond to member queries related to:

• Policy benefits, claim status, and claim adjustments

• Letter of Guarantee (LOG) issuance and prior approval processes

• Coverage details and basic benefit explanations
• Issue LOGs for members’ medical care to Medical Providers, ensuring compliance with policy terms, limits, and internal procedures.
• Coordinate closely with the medical team for emergency cases or complex approvals.
• Ensure strict adherence to turnaround times (TAT) and contribute to smooth call flow management.
• Identify and escalate complaints, unresolved cases, or potential fraud cases to supervisors or managers without delay.
• Contribute to continuous process improvement by identifying inefficiencies and proposing practical solutions to enhance service delivery.

• What we offer

• Comprehensive training and onboarding programs for new hires, including fresh graduates

• Career development opportunities to grow within the organization.

• A multicultural and dynamic work environment within a global company.

• Annual Leave

• Medical and Hospitalization Leave

• EPF

• SOCSO

• EIS

• Medical Insurance

• Training Provided

• Performance Bonus

• Overtime Pay

• 5 Working Days Work from Home