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.

职位名称	平均月薪	在招职位
Precertification And Customer Care Executive	1 在招职位	1 在招职位

MSH Sea Sdn Bhd

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