Full Time Healthcare Executive (Letter of Guarantee – LOG) Jobs, in HMI Managed Healthcare Federal Territory - Maukerja

Healthcare Executive (Letter of Guarantee – LOG)

About Us

HMI Managed Healthcare (MHC) is a third-party administrator that manages healthcare plans for insurers and corporate clients. Our Healthcare Services team makes sure members get timely access to care. We approve hospital admissions, issue Letters of Guarantee and work closely with providers and insurers.

What You’ll Do

• Review pre-authorisation requests and issue initial and supplementary LOGs (SLOGs) for our insurance and direct clients
• Assess cases accurately and on time against policy terms, meeting SLA and turnaround targets
• Handle early claim investigations, complex cases and appeals
• Liaise with hospitals, network providers and insurers to manage cases from admission to discharge
• Negotiate with network providers on cost-effective treatment options for members and clients
• Keep case records accurate and up to date in our systems

What We’re Looking For

• Diploma or above, with at least 2 years’ experience in health claims, medical insurance or hospital admissions
• Registered nurses or candidates with a nursing background who are looking for a career switch are welcome to apply
• A relevant insurance certification (e.g. Health Insurance certificate) is an advantage
• Good knowledge of medical terminology and policy interpretation
• Basic Excel skills; Salesforce experience is a plus
• Strong analytical, written and verbal communication skills in English
• Meticulous and customer-focused, able to multitask and work well under pressure
• A team player who works efficiently and accurately

Why Join Us

• Be part of a team that directly supports members’ access to care
• Gain exposure across insurers, corporate clients and a wide hospital network
• Medical coverage and a collaborative working environment