Dhs Claims Assessment, Specialist

3 months ago


Ho Chi Minh City, Vietnam AIA Full time

At AIA we’ve started an exciting movement to create a healthier, more sustainable future for everyone.
- It’s about finding new ways to not only better people's lives, but to better the communities and environments we live in. Encompassing our ambition of helping a billion people live Healthier, Longer, Better Lives by 2030._
- And to get there, we need ambitious people who believe in playing an important part in shaping that future. People seeking unmatched career and personal growth opportunities, who are driven to work with, and learn from some of the most inspiring and supportive leaders in the business._

Sound like you? Then read on.

About the Role

Report to: Manager, Healthcare Claims

Location: Ho Chi Minh City

Function: Customer Officer | Department: Digital Health Service

Role: Individual Contributor

THE OPPORTUNITY

We are looking for DHS Claims Assessment, Specialist who
- Handle direct billing claims within TAT and ensure to collaborate with medical provider staff well, proactively discuss with medical provider to give customer the best experiences and control expense reasonably.
- Perform customer centricity during the claim process.
- Proactively contribute creative ideas to the team to improve team performances and claim cost savings.

ROLE AND RESPONSIBILITIES

1. Direct Billing handling (80%)
- Ensure all direct billing cases are assessed thoroughly and timely and claims decisions within Claim Authority are made based on valid grounds as well as in full compliance with Claim guidelines/policies/ T&C.
- Work closely with hospital staff to ensure the treatment expenses are necessary and appropriate and avoid the abuse unnecessary.
- Document patients’ health information, including medical history, examination and test results, and any treatments or procedures provided.
- Preserve confidentiality of all patient records.
- Ensure to achieve claims SLA commitments to customers, distribution, and partner.
- Prepare accurate documentation, and if possible, recommendation on cases referred to higher authority level or to Claim Committee or re-insurers for decision.
- Proactively give good practice, ideas to the team to improve team performance.
- Performs other responsibilities and duties periodically assigned in order to support company’s business.

2. Reimbursement claim handling (20%)
- As a claim assessor, to be responsible for processing reimbursement claim if assigned by manager.
- Training for newcomers about the healthcare claim practice, medical knowledge if any

JOB REQUIREMENTS
- University Graduate.
- At least 2 years of experience in medical claim at an insurance company
- Certifications/licenses - LOMA certificate
- Good in communication and interpersonal skill, decision-making skill, management skill and planning skill.
- Medical background is preferred.
- Customer Service Approach
- Good in English speaking and writing
- Build a career with us as we help our customers and the community live Healthier, Longer, Better Lives._



  • Ho Chi Minh City, Vietnam AIA Full time

    At AIA we’ve started an exciting movement to create a healthier, more sustainable future for everyone. - It’s about finding new ways to not only better people's lives, but to better the communities and environments we live in. Encompassing our ambition of helping a billion people live Healthier, Longer, Better Lives by 2030._ - And to get there, we need...

  • Claims Specialist

    3 months ago


    Ho Chi Minh City, Vietnam Manulife Full time

    We are a leading financial services provider committed to making decisions easier and lives better for our customers and colleagues around the world. From our environmental initiatives to our community investments, we lead with values throughout our business. To help us stand out, we help you step up, because when colleagues are healthy, respected and...

  • Claims Specialist

    3 months ago


    Ho Chi Minh City, Vietnam Manulife Full time

    We are a leading financial services provider committed to making decisions easier and lives better for our customers and colleagues around the world. From our environmental initiatives to our community investments, we lead with values throughout our business. To help us stand out, we help you step up, because when colleagues are healthy, respected and...

  • Claims Specialist

    4 months ago


    Ho Chi Minh City, Vietnam Manulife Full time

    We are a leading financial services provider committed to making decisions easier and lives better for our customers and colleagues around the world. From our environmental initiatives to our community investments, we lead with values throughout our business. To help us stand out, we help you step up, because when colleagues are healthy, respected and...


  • Ho Chi Minh City, Vietnam Manulife Full time

    We are a leading financial services provider committed to making decisions easier and lives better for our customers and colleagues around the world. From our environmental initiatives to our community investments, we lead with values throughout our business. To help us stand out, we help you step up, because when colleagues are healthy, respected and...

  • Claims Administrator

    3 months ago


    Ho Chi Minh City, Vietnam April Asia Pacific Full time

    For over 30 years, APRIL International Care has been specializing in international health insurance solutions. We design, distribute, and manage insurance plans and assistance services for individuals and businesses. With teams across Asia, Europe, and the Americas, we look after our members wherever they are to make sure they have access to the best...

  • Claims Administrator

    4 months ago


    Ho Chi Minh City, Vietnam April Asia Pacific Full time

    For over 30 years, APRIL International Care has been specializing in international health insurance solutions. We design, distribute, and manage insurance plans and assistance services for individuals and businesses. With teams across Asia, Europe, and the Americas, we look after our members wherever they are to make sure they have access to the best...

  • Claims Administrator

    4 months ago


    Ho Chi Minh City, Vietnam April Asia Pacific Full time

    For over 30 years, APRIL International Care has been specializing in international health insurance solutions. We design, distribute, and manage insurance plans and assistance services for individuals and businesses. With teams across Asia, Europe, and the Americas, we look after our members wherever they are to make sure they have access to the best...


  • Ho Chi Minh City, Vietnam Prudential plc Full time

    Prudential's purpose is to help people get the most out of life. We will deliver our purpose by creating a culture in which diversity is celebrated and inclusion assured, for our colleagues, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and in exchange, we support our people's career...

  • Senior Claims Manager

    4 months ago


    Ho Chi Minh City, Vietnam Công Ty TNHH Xoài Việt Nam (Papaya Insurtech) Full time

    **Mô tả công việc**: (Mức lương: Thỏa thuận) - Approve claim settlement within designated authority limit. - Process claims for healthcare to meet committed TAT with partners. - Provide constant review of our claim assessment guidelines to the team to ensure that it is complied with our client‘s claim’s philosophy and negotiate with...

  • Claims Administrator

    4 months ago


    Ho Chi Minh City, Vietnam April Asia Pacific Full time

    **About the company**: For over 30 years, APRIL International Care has been specializing in international health insurance solutions. We design, distribute, and manage insurance plans and assistance services for individuals and businesses. With teams across Asia, Europe, and the Americas, we look after our members wherever they are to make sure they have...

  • Department Secretary

    4 months ago


    Ho Chi Minh City, Vietnam Công Ty TNHH Bosch Global Software Technologies Full time

    **Mô tả công việc**: (Mức lương: Thỏa thuận) 1. Department Activities - Support in welcoming guest, invitation letters, supporting accommodation, visa and travel, gift. - Prepare for new joiners (PC arrangement, create User ID, phone, taxi card, welcoming new associates ). - Prepare for resignation associates & conduct exit check-list. -...

  • General Assistant

    4 months ago


    Ho Chi Minh City, Vietnam Công ty TNHH Bosch Việt Nam Full time

    **Mô tả công việc**: (Mức lương: Thỏa thuận) **Job Description**: 1. Department Activities Support in welcoming guest, invitation letters, supporting accommodation, visa and travel, gift; Prepare for new joiners (PC arrangement, create User ID, phone, taxi card, welcoming new associates...); Prepare for resignation associates; do exit check...


  • Ho Chi Minh City, Vietnam Article Full time

    **Description**: Hi there, we’re Article. We’re a North American online furniture company creating remarkably better furniture experiences one sofa at a time. And as the **Why We Need You**: Within the Vendor Quality Team, our Vendor Quality Specialist will be conducting quality audits for vendors, developing quality standards, training stakeholders on...


  • Ho Chi Minh City, Vietnam Article Full time

    **Description**: Hi there, we’re Article. We’re a North American online furniture company creating remarkably better furniture experiences one sofa at a time. And as the **Why We Need You**: Within the Vendor Quality Team, our Vendor Quality Specialist will be conducting quality audits for vendors, developing quality standards, training stakeholders on...


  • Ho Chi Minh City, Ho Chi Minh, Vietnam People Profilers Vietnam Full time

    {"title": "Quality Control Specialist", "content": "Job SummaryWe are seeking a highly skilled Quality Control Specialist to join our team at People Profilers Vietnam. As a Quality Control Specialist, you will be responsible for ensuring that our products meet the highest quality standards.Key ResponsibilitiesEnforce and ensure the organization's quality...


  • Ho Chi Minh City, Vietnam Công Ty TNHH Article Solutions Việt Nam Full time

    **Mô tả công việc**: (Mức lương: Thỏa thuận) Why We Need You: Within the Vendor Quality Team, our Vendor Quality Specialist will be conducting quality audits for vendors, developing quality standards, training stakeholders on quality requirements, working on corrective actions, and providing support for escalated issues within a specific...


  • Thành phố Hồ Chí Minh, Vietnam Công Ty TNHH Amaris Việt Nam Full time

    **Mô tả công việc**: (Mức lương: Thỏa thuận) ABOUT THE JOB - Lead the overall technical assurance definition and execution of the Technology Assurance framework and programs - Provide expertise level guidance on compliance requirements related to technology for control/process documentation, testing, and issue management - Collaborate with...


  • Thành phố Hồ Chí Minh, Vietnam Amaris Consulting Full time

    **Who are we? **:**Amaris Consulting** is an independent technology consulting firm providing guidance and solutions to businesses. With more than 1,000 clients across the globe, we have been rolling out solutions in major projects for over a decade - this is made possible by an international team of 7,600 people spread across 5 continents and more than 60...


  • Thành phố Hồ Chí Minh, Vietnam amaris Full time

    Job description ABOUT THE JOB Lead the overall technical assurance definition and execution of the Technology Assurance framework and programs Provide expertise level guidance on compliance requirements related to technology for control/process documentation, testing, and issue management Collaborate with Group InfoSec Governance to assess critical and key...