Case Management Advisor - Cantonese Speaker

Title: Case Management Advisor - Cantonese Speaker

Working Hours: 9AM - 6PM, Monday - Friday

Location: Kuala Lumpur, Malaysia

Salary: RM 4500 RM 5500 (basic salary) + RM 400 (fixed language allowance) + RM 200 (fixed transport allowance)

Job Descriptions:

1. Review and assess pre-authorization (PA) requests from members or providers for completeness, accuracy, and eligibility in accordance with policy terms and conditions.

2. Verify medical charges against appropriate diagnosis, procedure, and medical codes to ensure consistency and compliance.

3. Communicate Pre-authorization results to members or providers within the service level agreements

4. Request additional information or clarification from members or providers to support PA decisions

5. Escalating complex or exceptional cases to senior advisors or supervisors as needed

Job Requirements:

1. With 1-3 years of experience in Pre-authorization or medical claims processing

2. With Healthcare background is preferred

3. With knowledge of medical terminology, billing codes (ICD 9, ICD 10, CPT) and medical insurance polices is preferred

4. Good time management skill and ability to multitask