Senior Manager, Individual Benefit Cashless Claim

• →Manage daily Cashless Medical Claims and GL operations for IB and Additional Guarantee requests for IB & EB portfolios.
• →Ensure cases are assessed accurately and completed within established TATs and service standards.
• →Monitor productivity, inventory, backlog, ageing cases and case clearance.
• →Handle complex, urgent and escalated cases while ensuring appropriate resolution.
• →Lead, coach and develop Team Leaders and staff to achieve operational and service objectives.
• →Drive performance management, workforce planning and capability development.
• →Manage key stakeholders including Contact Centre, Branches, Customer Service, Technology, Takaful, Underwriting, Claims, Medical Management and other business units.
• →Collaborate with panel hospitals and healthcare providers to ensure smooth cashless admission services.
• →Manage customer, agent, provider and management escalations, ensuring timely resolution.
• →Ensure compliance with operational guidelines, governance requirements, policies and regulatory standards.
• →Drive process improvements, automation initiatives and operational excellence projects.
• →Prepare and present operational performance reports, service metrics and management updates.

• Degree in Insurance, Healthcare, Business Administration or related field.
• Minimum 8 years of experience in medical claims, cashless operations or healthcare administration.
• Minimum 3 years of leadership experience managing operational teams.
• Strong knowledge of medical claims assessment, Guarantee Letter operations, healthcare providers and insurance operations.
• Strong stakeholder management, problem-solving and decision-making skills.
• Experience managing escalations, service delivery and operational improvement initiatives.

Build a career with us as we help our customers and the community live Healthier, Longer, Better Lives.

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