Job Title: Senior Operations Executive (HealthTech Claims)

Location: Malaysia

Job Type: Full-time, Remote

Key Responsibilities

• Manage a portfolio of complex claims, ensuring prompt, accurate, and transparent processing in line with internal SLAs and regulatory standards.
• Act as a Subject Matter Expert (SME) for the claims and customer service teams, providing guidance, training, and support to resolve escalated cases and develop best practices.
• Investigate, assess, and adjudicate claims, which includes reviewing documentation, analyzing digital health records, and using data analytics to determine eligibility, coverage, and liability.
• Monitor, analyze, and report on claims performance using KPIs and dashboards.
• Drive data-driven process improvement projects focused on increasing automation, accuracy, and customer satisfaction.
• Ensure strict compliance with company policies, industry regulations, and evolving digital health legislation across Asia.
• Proactively identify operational risks and recommend effective process or technology improvements.
• Collaborate cross-functionally with product and tech teams on system enhancements and to resolve customer enquiries.
• Maintain accurate claims databases, generate management reports, and process all "Business as Usual" (BAU) operational tasks.

Qualifications

• Education: Bachelor's degree in Business, Finance, Insurance, Health Administration, or a related field.
• Experience: A minimum of 2-3 years of experience in claims management, ideally from the life/health insurance sector or a digital health platform operating in Asia.
• Language: Trilingual proficiency is mandatory. Full professional fluency in Cantonese, Mandarin, and English is required.
• Technical Skills: Experience with claims operating systems, workflow automation, and data analytics tools is highly preferred.
• Knowledge: Sound knowledge of insurance regulations, industry standards, and digital health compliance requirements in Asia.
• Abilities:
  • Strong analytical, investigative, and problem-solving skills.
  • Demonstrable communication and negotiation skills, with experience engaging diverse stakeholders.
  • Ability to adapt and perform in a fast-paced, digital-first business environment.
  • Proven ability to work independently and manage competing priorities.

How to Apply

Interested candidates are invited to submit their resume, detailing their experience in claims management and their language proficiencies.