- Unit 7-2 Menara 1 Sentrum Floor Level 7, Menara 1 Sentrum, Jalan Tun Sambanthan, WP Kuala Lumpur, Malaysia, 50470, Kuala Lumpur, WP Kuala Lumpur, 50470, Malaysia Kuala Lumpur WP Kuala Lumpur Malaysia 50470

Working Location
Job Description
Requirements
Diploma or Degree in Medical Sciences, Languages, Office Administration or any related field
Minimum 1 year of experience in customer service, call centre or any customer-facing role
Excellent command of English (spoken and written) is mandatory
Strong communication skills with the ability to handle complex inquiries professionally
Fast learner with the ability to adapt quickly in a fast-paced, high-call-volume environment
Proficient in Microsoft Office, email management and general IT systems
Prior experience in insurance, Third Party Administration (TPA) or medically related establishments is an added advantage
Fluency in additional languages such as Mandarin, French, Japanese, Thai, Korean or Spanish is a strong plus and may result in higher compensation
Responsibilities
Deliver high-quality customer service to insured members by managing high volumes of incoming and outgoing calls professionally and efficiently
Process simple adjustment claims and reimbursement requests accurately within defined Service Level Agreements (SLAs)
Respond to member queries related to policy benefits, claim status, claim adjustments and coverage details
Issue Letter of Guarantee (LOG) to medical providers in compliance with policy terms, limits and internal procedures
Handle prior approval processes and assist members in understanding their benefit entitlements
Coordinate with the medical team for emergency cases and complex approvals
Ensure strict adherence to turnaround times (TAT) and maintain smooth call flow management
Identify and escalate complaints, unresolved cases or potential fraud cases to supervisors promptly
Benefits
LRT - MASJID JAMEK
0.3 km
LRT - PASAR SENI
0.6 km
MRT - PASAR SENI
0.6 km
KTM - BANK NEGARA
0.8 km
LRT - BANDARAYA
0.9 km
KTM - KUALA LUMPUR
0.9 km
LRT - PLAZA RAKYAT
1.0 km
MRT - MERDEKA
1.1 km
MRL - MAHARAJALELA
1.2 km
LRT - DANG WANGI
1.3 km
MRL - MEDAN TUANKU
1.4 km
MRT - MUZIUM NEGARA
1.4 km
LRT - SULTAN ISMAIL
1.5 km
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