全职 Panel Administration Executive 工作, 薪水 up to MYR 3,000, Wong & Sim Dental Surgery Pulau Pinang 公司招聘中 - Ricebowl

Job Purpose

To manage and coordinate all corporate, insurance and third-party administrator (TPA) panel matters across the Group, ensuring accurate claim submissions, timely collection of payments, proper documentation and consistent panel procedures across all branches.

1. Key Responsibilities1. Panel Administration

• Manage all existing corporate, insurance and TPA panel accounts across the Group.
• Handle applications and onboarding for new panels and new clinic branches.
• Maintain an updated master list of panels, participating branches, fee schedules, coverage limits, contact persons and claim requirements.
• Manage panel renewals, updates to clinic information, dentist details, bank details and other required documentation.
• Liaise with panel providers regarding administrative and operational matters.

2. Claims Management

• Coordinate and process panel claims submitted by all branches.
• Review claims for completeness and accuracy before submission.
• Ensure claims are submitted within the required timelines.
• Track the status of submitted, pending, rejected and resubmitted claims.
• Investigate rejected or disputed claims and coordinate corrections with the relevant clinic.
• Follow up with panel providers on delayed or outstanding claims.

3. Payment & Reconciliation

• Maintain records of claims submitted versus payments received.
• Reconcile panel payment statements against claims and clinic records.
• Identify unpaid, partially paid or incorrectly paid claims.
• Follow up on outstanding panel receivables.
• Work closely with the Finance team to ensure payments are correctly identified and allocated to the respective clinics.
• Prepare ageing reports for outstanding panel claims.

4. Branch Coordination

• Act as the central point of contact for all branches regarding panel matters.
• Guide clinic PICs/front desk staff on panel eligibility, documentation and claim procedures.
• Ensure all branches follow standardised panel SOPs.
• Communicate changes in panel policies, fee schedules, claim requirements or coverage to affected branches.
• Assist branches in resolving panel-related patient or administrative issues.

5. Panel Records & Compliance

• Maintain proper electronic filing of panel agreements, correspondence, claims and payment records.
• Ensure patient and claim information is handled confidentially.
• Monitor compliance with individual panel requirements and internal company SOPs.
• Ensure supporting documents such as invoices, treatment records, authorisation forms and claim forms are properly maintained.

6. Reporting

Prepare regular management reports covering:

• Total claims submitted
• Claims approved and paid
• Outstanding claims
• Rejected/disputed claims
• Outstanding amount by panel and branch
• Average collection/processing time
• Recurring claim issues by branch

Highlight significant overdue claims, recurring rejection issues and operational problems to Management.

Key Performance Indicators (KPIs)

Performance may be measured based on:

• Claim submission accuracy
• Claim rejection rate
• Percentage of claims submitted within deadline
• Outstanding panel receivables
• Average claim collection period
• Timeliness of rejected-claim resolution
• Accuracy of reconciliation
• Completeness of panel records
• Responsiveness to branch enquiries

Requirements

• Diploma/Degree in Business Administration, Finance, Healthcare Administration or related field preferred.
• Experience in healthcare, dental, medical, insurance, TPA or claims administration is an advantage.
• Strong attention to detail and numerical accuracy.
• Good organisational and follow-up skills.
• Comfortable working with Excel/Google Sheets and multiple online panel portals.
• Able to coordinate effectively with multiple clinic branches.
• Good communication skills in English and Bahasa Malaysia.
• Able to work independently and manage deadlines.

Role Expectation

The Panel Administration Executive is expected to take ownership of panel administration from claim submission until payment collection, rather than functioning solely as a data-entry or claim-submission role.

The Executive should proactively identify outstanding claims, resolve discrepancies and ensure that panel revenue due to the Group is collected accurately and on time.

Pay: RM2,000.00 - RM3,000.00 per month

Benefits:

• Maternity leave

Application Question(s):

• Have you handled insurance, corporate or TPA panel claims before?

Work Location: In person