4 Child Welfare 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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#J-18808-Ljbffr

Vacancy: Native Korean - Social Media Customer Services Agent
br>Location: Kuala Lumpur, Malaysia

Salary: RM 8,800

Language: Korean + English

Timing: Rotational Shift

Project: Social media

Education: Diploma or Bachelor

Headcount: 10

Start Date: 15th July 2025 (Immediate joiner)

Job Expectations:

- Respond to customer inquiries via call (50%) and chat (50%)
- Manage customer escalations and ensure timely resolution
- Perform procedures accurately, including data entry and complaint management
- Meet all SLAs and demonstrate strong customer service orientation
- Communicate effectively with customers in a friendly and polite manner

*Skills Required:*

- Diploma or Bachelor's Degree with 1+ year of customer service experience
- Excellent communication skills and command over Korean and English languages
- Strong customer service skills

_NOTE: The company will handle paperwork and relocation expenses._

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