8 Case Management jobs in Malaysia

Medical Advisory, Case & Fraud Management, Specialist

AIA Malaysia Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia Join or sign in to find your next job

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Medical Advisory, Case & Fraud Management, Specialist

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AIA Malaysia Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia Join to apply for the

Medical Advisory, Case & Fraud Management, Specialist

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AIA Malaysia 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

To identify pattern of fraud, waste, and abuse in case management. To implement measures required for risk management. To conduct surgical and medical history check on claims . To identify breach of duty of good faith and non-disclosure To ensure risk are priced correctly and non-disclosed conditions excluded accurately and modified To perform prospective, concurrent and retrospective review of hospitalization To ensure cost containment measures without compromising on the care quality and service standards.

Job Responsibilities

To provide Medical Advisory including disputed charges, appeals and critical issues. To ensure the Fraud tool is maintained and handled with care with insightful monthly analysis. Proficient with medical coding, 13th Schedule, MOH letters, reasonable and customary charges. To conduct Amount Under Clarification (AUC) and case management, regular audits, and handle critical issues to identify Fraud, Waste and Abuse. To ensure claim adjudication is in accordance with reasonable and customary charges and to review trending of doctors / members / agents that may or may not be in the watch list. To outline process improvement, cost saving measures, combating Fraud, Waste, and Abuse methods from audits. To build claim guides that collaborates with clinical guides and cost containment with effective implementation. To conduct robust medical training aligned with technical aspects of claims processing including training to hospitals. To actively engage with collaborators for recovery and remedial actions including doctors under supervision and non-participating list of doctors / agents / hospitals / members. To mentor/coach and guide the TLs and assessors in robust decision making. To proactively identify and collaborate on the needful system improvement and process automation. To provide timely reporting and communication of all initiatives across all units in AIA. To participate and represent Medical Advisory, Case, and Fraud management in all vital initiatives.

Minimum Job Requirements

Candidate must possess at least a Bachelor's Degree or Diploma or equivalent experience Min 5 years of medical claim experience Technical Skills: Claims assessment, medical report knowledge, Health Insurance Policy knowledge. Industry: Insurance, Third-Party Administrator, Hospitals, Clinics, Medical Labs. Language: English and Bahasa Malaysia.

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

You must provide all requested information, including Personal Data, to be considered for this career opportunity. Failure to provide such information may influence the processing and outcome of your application. You are responsible for ensuring that the information you submit is accurate and up-to-date. Seniority level

Seniority level Mid-Senior level Employment type

Employment type Full-time Job function

Job function Health Care Provider Industries Insurance Referrals increase your chances of interviewing at AIA Malaysia by 2x Sign in to set job alerts for “Medical Specialist” roles.

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Medical Advisory, Case & Fraud Management, Specialist

Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 1 week ago Quality Reviewer (Medical Pre-Underwriting - Health Insurance)

Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 2 weeks ago Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 3 weeks ago Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 1 month ago Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 2 months ago Medical Sales Representative ( Klang Valley)

Federal Territory of Kuala Lumpur, Malaysia 2 weeks ago Manager, Medical Advisor & Case Management

Petaling Jaya, Selangor, Malaysia 8 hours ago Asia Medical Malpractice & Professional Indemnity Claims Manager

Federal Territory of Kuala Lumpur, Malaysia 1 week ago Petaling Jaya, Selangor, Malaysia 3 days ago We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.

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1 day ago Be among the first 25 applicants

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Direct message the job poster from Asia Eye Specialist Centre

Integrity. Passionate. Forward Thinking.

Job Title: Patient Care Consultant

Employment Type: Full-time

About Us:

We are a leading eye specialist centre dedicated to providing cutting-edge treatments in vision correction, including LASIK and cataract surgeries. Our team of experienced ophthalmologists and eye care professionals is committed to delivering the highest standard of patient care and visual outcomes.

Job Overview:

We are seeking a dynamic and customer-focused Patient Care Consultant to join our team. The ideal candidate will play a key role in guiding prospective patients through the consultation and decision-making process for LASIK and cataract procedures, ensuring a seamless and supportive experience from first inquiry to treatment.

Key Responsibilities:

• Lead Conversion & Consultations:
• Engage with potential patients via phone, email, walk-ins, and digital platforms.
• Educate prospective patients about LASIK and cataract surgery options, procedures, and benefits.
• Conduct initial patient consultations and suitability assessments (non-clinical).
• Follow up on leads and convert inquiries into booked procedures.
• Customer Experience:
• Provide outstanding service throughout the patient journey.
• Coordinate with clinical staff to ensure timely scheduling and information flow.
• Address patient concerns and objections with empathy and factual clarity.
• Maintain patient records and track progress from inquiry to post-surgery follow-up.
• Meet and exceed monthly conversion targets and KPIs.
• Maintain accurate and timely reporting of sales metrics.
• Collaborate with the marketing team to refine campaigns based on lead quality and patient feedback.
• Operational Support:
• Assist with clinic events, open days, and promotional activities.
• Ensure patient-facing materials are up to date and in line with branding.
• Stay informed on the latest in LASIK and cataract technology and techniques.

Qualifications & Requirements:

• Proven experience in a sales or patient care consultant role, preferably in healthcare, optical, or medical aesthetics.
• Strong communication and interpersonal skills.
• Customer-oriented mindset with a compassionate and ethical approach.
• High attention to detail and ability to handle confidential information.
• Comfortable working in a target-driven environment.
• Proficiency in CRM systems and Microsoft Office.
• Knowledge of LASIK and cataract procedures is a strong advantage (training will be provided).

What We Offer:

• Competitive salary with attractive commission structure.
• Supportive and professional work environment.
• Opportunities for growth within a rapidly expanding medical practice.

Seniority level

• Seniority level Entry level

Employment type

• Employment type Full-time

Job function

• Job function Health Care Provider
• Industries Medical Practices

Referrals increase your chances of interviewing at Asia Eye Specialist Centre by 2x

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Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 4 days ago

Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 2 weeks ago

Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 1 month ago

Programme Coordinator cum Lecturer (Diploma in Healthcare) Manager, Provider Management & Connected Care

Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 1 month ago

Regional Brand Manager, Tissue & Personal Care International Market

Bukit Raja, Selangor, Malaysia 17 hours ago

Partnership Manager (Vision Care Franchise)

Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 11 hours ago

Global Network - Management Consulting Analyst (CL11)

Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 3 weeks ago

Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 1 week ago

Assistant Brand Manager, Adult & Feminine Care Project Manager (Primary Care) - Community Outreach Unit Sales Manager - Advanced Wound Care (East Coast Region)

Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 2 weeks ago

Petaling Jaya, Selangor, Malaysia 3 months ago

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Posting Date

04/07/2025

4084 Riverside Parkway Suite 100, Leesburg, Virginia, 20176, United States of America

DaVita is seeking a Patient Care Technician who is looking to give life in an outpatient dialysis center. This is a Nocturnal position with evening hours.

Schedule:

Sunday, Tuesday, Thursday

4pm - 12:30am

Requirements:

• Desire to enter the health care field to care for other people in need.
• High school diploma or equivalent.
• Must be comfortable working around blood and needles.
• Must be comfortable mixing acid or bicarb.
• Physical and mental ability to work long hours (some shifts are 12+ hours) on your feet, so wear comfortable shoes! Our work ends when it's safe for our patients.
• Willingness to train and work across multiple clinics within the territory as needed.
• Health care experience a plus including: BONENT Certified, Certified Hemodialysis Technician (CHT), Certified Nursing Assistant (CNA), Certified Medical Assistant (CMA), or Phlebotomy certification.

You can make an exceptional difference in the lives of our patients and their families dealing with end-stage renal failure or chronic kidney disease. Do you desire to deliver care in an empathetic, compassionate way - the way you'd want your own care to be?

Joining DaVita as Patient Care Technician (PCT) is an exciting opportunity to jump start your career in the health care industry! With paid, extensive training, you will gain the skills needed to care for our patients and build a network of other health care professionals across the geography where you live. Once you have successfully completed training, you will join a holistic team of care professionals – including nurses, dietitians, social workers, and other experienced PCTs – to care for our patients. It's not a job, it's giving life and a career based on passion and purpose.

Some details about this position:

• No Dialysis experience is required.
• Training may take place in a facility or a training clinic other than your assigned home clinic.
• Potential to float to various clinics during and after your training.
• You must have a flexible schedule and be able to work mornings, evenings, weekends, and holidays.

What you can expect:

• Direct Patient Care. Spend the majority of your day in direct one-on-one patient care to provide safe, comfortable and hygienic dialysis treatment.
• Our PCTs care for multiple patients.
• Technician Duties. Monitor patients before, during and after dialysis treatment including measuring and recording stats, patient observations, and hemodialysis machine setup. Please note you will have exposure to blood and needles.
• Building long-term relationships with your patients who are suffering from end stage renal disease and are receiving treatment on average 3 times/week. You will also be responsible for educating patients on Kidney Dialysis related topics.
• Team. Cross functional team of clinicians including technicians, nurses, dietitians, social workers, and leadership. PCTs work under the supervision of a RN.

What we'll provide:

• Comprehensive benefits: Medical, dental, vision, 401(k) match, paid time off, PTO cash out.
• Support for you and your family: family resources, EAP counseling sessions, access Headspace, backup child and elder care, maternity/paternity leave, pet insurance, and more.
• Paid training.

DaVita is a clinical leader! We have the highest percentage of facilities meeting or exceeding CMS's standards in the government's two key performance programs. We expect our teammates to commit to improving patient health through clinical goal setting and quality improvement initiatives.

Ready to make a difference in the lives of patients? Take the first step and apply now.

At DaVita, we strive to be a community first and a company second. We want all teammates to experience DaVita as "a place where I belong." Our goal is to embed belonging into everything we do in our Village, so that it becomes part of who we are. We are proud to be an equal opportunity workplace and an affirmative action employer.

This position will be open for a minimum of three days.

Salary/Wage Range:

Compensation for the role will depend on a number of factors, including a candidate’s qualifications, skills, competencies and experience. DaVita offers a competitive total rewards package, which includes a 401k match, healthcare coverage and a broad range of other benefits.

Colorado Residents: Please do not respond to any questions in this initial application that may seek age-identifying information such as age, date of birth, or dates of school attendance or graduation. You may also redact this information from any materials you submit during the application process.

About Us

DaVita (NYSE: DVA) is a comprehensive kidney care provider focused on transforming care to improve the quality of life for patients globally. The company is a leading provider of kidney care services in the U.S. and has been a leader in clinical quality and innovation for more than 20 years.

DaVita is an equal opportunity employer - Male/Female/Veterans/Disabled. We maintain a drug-free workplace and perform pre-employment substance abuse testing and background verification checks.

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1 day ago Be among the first 25 applicants Get AI-powered advice on this job and more exclusive features. Direct message the job poster from Asia Eye Specialist Centre Integrity. Passionate. Forward Thinking.

Job Title: Patient Care Consultant Employment Type:

Full-time About Us: We are a leading eye specialist centre dedicated to providing cutting-edge treatments in vision correction, including LASIK and cataract surgeries. Our team of experienced ophthalmologists and eye care professionals is committed to delivering the highest standard of patient care and visual outcomes. Job Overview: We are seeking a dynamic and customer-focused Patient Care Consultant to join our team. The ideal candidate will play a key role in guiding prospective patients through the consultation and decision-making process for LASIK and cataract procedures, ensuring a seamless and supportive experience from first inquiry to treatment. Key Responsibilities: Lead Conversion & Consultations: Engage with potential patients via phone, email, walk-ins, and digital platforms. Educate prospective patients about LASIK and cataract surgery options, procedures, and benefits. Conduct initial patient consultations and suitability assessments (non-clinical). Follow up on leads and convert inquiries into booked procedures. Customer Experience: Provide outstanding service throughout the patient journey. Coordinate with clinical staff to ensure timely scheduling and information flow. Address patient concerns and objections with empathy and factual clarity. Maintain patient records and track progress from inquiry to post-surgery follow-up. Meet and exceed monthly conversion targets and KPIs. Maintain accurate and timely reporting of sales metrics. Collaborate with the marketing team to refine campaigns based on lead quality and patient feedback. Operational Support: Assist with clinic events, open days, and promotional activities. Ensure patient-facing materials are up to date and in line with branding. Stay informed on the latest in LASIK and cataract technology and techniques. Qualifications & Requirements: Proven experience in a sales or patient care consultant role, preferably in healthcare, optical, or medical aesthetics. Strong communication and interpersonal skills. Customer-oriented mindset with a compassionate and ethical approach. High attention to detail and ability to handle confidential information. Comfortable working in a target-driven environment. Proficiency in CRM systems and Microsoft Office. Knowledge of LASIK and cataract procedures is a strong advantage (training will be provided). What We Offer: Competitive salary with attractive commission structure. Supportive and professional work environment. Opportunities for growth within a rapidly expanding medical practice. Seniority level

Seniority level Entry level Employment type

Employment type Full-time Job function

Job function Health Care Provider Industries Medical Practices Referrals increase your chances of interviewing at Asia Eye Specialist Centre by 2x Sign in to set job alerts for “Care Consultant” roles.

Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 4 days ago Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 2 weeks ago Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 1 month ago Programme Coordinator cum Lecturer (Diploma in Healthcare)

Manager, Provider Management & Connected Care

Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 1 month ago Regional Brand Manager, Tissue & Personal Care International Market

Bukit Raja, Selangor, Malaysia 17 hours ago Partnership Manager (Vision Care Franchise)

Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 11 hours ago Global Network - Management Consulting Analyst (CL11)

Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 3 weeks ago Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 1 week ago Assistant Brand Manager, Adult & Feminine Care

Project Manager (Primary Care) - Community Outreach Unit

Sales Manager - Advanced Wound Care (East Coast Region)

Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 2 weeks ago Petaling Jaya, Selangor, Malaysia 3 months ago We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.

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Zuellig Pharma (ZP) is one of the largest healthcare services groups in Asia and our purpose is to make healthcare more accessible.

For over 100 years, we have been the trusted partner for healthcare companies looking to realize opportunities in Asian markets. With our deep-reaching infrastructure and sole focus on healthcare, we offer our clients unparalleled access to all healthcare channels across 13 countries in the region. Our focus is always about combining our market insight with a thorough understanding of your needs to deliver the best solution that connects you to patients. We believe delivering your products is only the first step to capturing the Asian markets. That is why we have continued to invest in developing innovative solutions that expand across Distribution, Clinical Reach, Sales & Marketing, Patient Centered Services, and Community Pharmacies.

Zuellig Pharma is the leading provider of distribution services to manufacturers in the life science industry in the Asia Pacific region. With operations in 13 countries or territories Zuellig Pharma has strong market positions, critical mass, broad geographic coverage and significant potential for continuing growth.

Purpose of the Role : PatientCare Program Officer works within the PatientCare team to provide and execute administrative duties related to program enrolment and management. You are expected to engage with the program to provide an excellent patient /customer service experience and meet service levels and standards.

Expectations of the Role:

• Provision of personalised patient case management and ensuring patients is submitting relevant program document on a timely basis
• Answering of inbound calls or outbound calls and attend to FAQ-related enquiries
• Assist in ensuring that programs are delivered within the appropriate service levels and standards including, but not limited to, case handling time, pre-defined protocols, and confidentiality of patient data
• Ensure that all appropriate information obtained during patient interactions are entered and saved in the PatientCare Management System and program standard operation procedures (SOPs) are always adhered to and compiled with.
• Responsible for the reporting of Adverse Events made aware of during interaction with patients or healthcare professionals within agreed duration
• Preparing of periodic or ad hoc program reports
• Proactively sharing of information among team members to enhance existing services to patients
• Be prepared to back up other team members to ensure enough covering for daily operations
• Deliver any other duties as assigned by the Operations Manager

Attributes Required:

Must-Have:

• Nursing or related medical / science or community nursing / support background is preferred.
• Fresh graduates are welcome to apply

Advantage to Have:

• Related healthcare/customer service industrial attachment/working experience is preferred.
• We are committed to fostering an inclusive environment where our employees can learn, grow, and achieve shared success.
• We champion diversity, equity, and inclusion, ensuring every individual feels valued, respected, and treated fairly.
• As a leading multi-market healthcare solutions provider, we empower our employees to gain comprehensive knowledge and expertise in the dynamic healthcare industry across the region.
• Enjoy the flexibility to effectively balance your work and personal life while taking charge of your career journey through our empowering growth opportunities.
• Our Total Rewards program is designed to support your overall well-being in every aspect.

Seniority level

• Seniority level Associate

Employment type

• Employment type Full-time

Job function

• Job function Health Care Provider and Customer Service
• Industries Pharmaceutical Manufacturing

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Position: Patient Care Coordinator (Kuala Lumpur)

Position Purpose: The Patient Care Coordinator will assist the Patient Care Leader in managing drug access program(s) in the region. The jobholder is required to help represent Axios in daily meetings with patients, doctors and carry out administration tasks.

About the Company

A healthcare access company with 20+ years of experience developing sustainable solutions to patient access challenges in emerging markets through Patient Assistance Programs and Patients Support Programs.

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We're looking for someone who's always online, curious about what's happening in Malaysia,

and has a sharp eye for social media trends. If you're fluent in Mandarin, Bahasa Malaysia, and

English – and love navigating the fast-moving world of online conversations – you might just be

who we’re looking for.

Key Responsibilities

• Monitor social media conversations, news mentions, and online content related to our
  
  
  

clients’ brand identities, products, and public discourse.

• Identify and flag negative or sensitive content in real time.
• Cleanse and manage large datasets—filter and categorize content into relevant themes.
• Analyze big volumes of news, posts, and public comments.
• Prepare and send daily online media monitoring alerts via email.
• Work on rotating shifts (including nights, weekends, and public holidays).
  
  
  

Who We’re Looking For

• Minimum qualification: SPM or Higher Secondary.
• Fluent in Mandarin, Bahasa Malaysia, and English—both written and spoken.
• Skilled in Microsoft Office, especially Excel.
• Preliminary knowledge of social media platforms and tools is an advantage.
• Open to fresh graduates; those with at least 1 year of experience are encouraged to
  
  
  

apply.

• Detail-oriented, analytical, and curious about current affairs.
• Able to stay focused and accurate under pressure and tight deadlines.
• Willing to roll up your sleeves to get things done.
• Must be ethical, trustworthy, and able to work independently
  
  
  

Interested candidates please submit your application through Jobstore #J-18808-Ljbffr