8 Social Work 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

Join to apply for the Medical Advisory, Case & Fraud Management, Specialist role at AIA Malaysia

Continue with Google Continue with Google

Medical Advisory, Case & Fraud Management, Specialist

AIA Malaysia Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia

Join to apply for the Medical Advisory, Case & Fraud Management, Specialist role at 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.

Continue with Google Continue with Google

Continue with Google Continue with Google

Petaling Jaya, Selangor, Malaysia 2 days ago

Federal Territory of Kuala Lumpur, Malaysia 1 week ago

Malay OPIVRI Medical Interpretation Vacancy

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

Contract Associate, Contact Centre (The Great Journey - Medical Claim)

Federal Territory of Kuala Lumpur, Malaysia 3 days ago

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

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

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

Medical Sales Representative ( Govt Hosp Team)

Federal Territory of Kuala Lumpur, Malaysia 1 week ago

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

Medical Advisor, Oncology & Specialty Care, Malaysia Therapy Specialist (Clinical Application Nurse)

Petaling Jaya, Selangor, Malaysia 5 days ago

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

Petaling Jaya, Selangor, Malaysia 1 day ago

Quality Reviewer - (Medical Pre-Underwriting - Health Insurance) 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.

#J-18808-Ljbffr

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

Join to apply for the

Medical Advisory, Case & Fraud Management, Specialist

role at

AIA Malaysia Continue with Google Continue with Google Medical Advisory, Case & Fraud Management, Specialist

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

Medical Advisory, Case & Fraud Management, Specialist

role at

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.

Continue with Google Continue with Google Continue with Google Continue with Google Petaling Jaya, Selangor, Malaysia 2 days ago Federal Territory of Kuala Lumpur, Malaysia 1 week ago Malay OPIVRI Medical Interpretation Vacancy

Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 1 month ago Contract Associate, Contact Centre (The Great Journey - Medical Claim)

Federal Territory of Kuala Lumpur, Malaysia 3 days ago Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 2 weeks ago WP. Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 3 weeks ago Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 1 week ago Medical Sales Representative ( Govt Hosp Team)

Federal Territory of Kuala Lumpur, Malaysia 1 week ago Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 2 weeks ago Medical Advisor, Oncology & Specialty Care, Malaysia

Therapy Specialist (Clinical Application Nurse)

Petaling Jaya, Selangor, Malaysia 5 days ago Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 1 month ago Petaling Jaya, Selangor, Malaysia 1 day ago Quality Reviewer - (Medical Pre-Underwriting - Health Insurance)

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.

#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._

Are you a qualified Adult Social Worker looking for temporary work?

Sensible Staffing is currently recruiting Adult Social Workers to join teams across various service areas, including:
Learning Disabilities
Safeguarding
Mental Health
Forensic Social Work
Intervention & Crisis Support

Key Responsibilities:

Conduct assessments and care planning to support adults with a range of needs.

Provide safeguarding support , managing risk and ensuring compliance with legal frameworks.

Work with individuals to promote independence, well-being, and positive outcomes .

Collaborate with multi-agency teams , including health professionals, housing, and legal services.

Maintain accurate case records and contribute to service improvements.

Requirements:

Degree in Social Work (or equivalent qualification).
Registered with Social Work England (or relevant body) .
Experience in at least one of the following areas: Learning Disabilities, Safeguarding, Mental Health, Forensic, or Crisis Intervention .
Strong understanding of relevant legislation (Care Act, Mental Capacity Act, Mental Health Act).
Ability to work independently and within a team .
A flexible and proactive approach to work.

Why Work with Sensible Staffing?

Competitive pay rates and flexible working arrangements.
Opportunities to gain experience across multiple specialisms .
Ongoing support from a dedicated recruitment consultant.
Access to exclusive job opportunities across local authorities and NHS trusts.

If you are applying for the first time, please complete all fields below

Already registered with Sensible Staffing? Just enter your name, contact number and email.

#J-18808-Ljbffr

sector:

sub-sector: Community

type: Temporary

location: South West

Are you a qualified Children’s Social Worker looking for flexible temporary work?

Sensible Staffing is currently recruiting Children’s Social Workers to join teams across various service areas, including:

Safeguarding
Child Protection
Fostering
Family Support & Social Services
Adoption

We welcome applications from social workers with experience in at least one of these areas.

Key Responsibilities:

• Conduct assessments and care planning to safeguard and support children and families.
• Work closely with children at risk, ensuring their safety and well-being .
• Support foster carers, adoptive parents, and families in need of intervention.
• Provide direct support and advocacy for children and young people.
• Collaborate with multi-agency teams , including education, health, and legal services.
• Maintain accurate case records and contribute to service improvements.

Requirements:

Degree in Social Work (or equivalent qualification).
Registered with Social Work England (or relevant body) .
Experience in at least one of the following areas: Safeguarding, Child Protection, Fostering, Family Support, or Adoption .
Strong understanding of relevant legislation (Children Act, Working Together to Safeguard Children, Care Planning Regulations).
Ability to work independently and within a team .
A compassionate and proactive approach to working with children and families.

Why Work with Sensible Staffing?

Competitive pay rates and flexible working arrangements.
Opportunities to gain experience across multiple children’s services .
Ongoing support from a dedicated recruitment consultant.
Access to exclusive job opportunities across local authorities and children’s trusts.

If you are applying for the first time, please complete all fields below

Already registered with Sensible Staffing? Just enter your name, contact number and email.

#J-18808-Ljbffr

Are you a qualified Adult Social Worker looking for temporary work? Sensible Staffing is currently recruiting

Adult Social Workers

to join teams across various service areas, including: Learning Disabilities Safeguarding Mental Health Forensic Social Work Intervention & Crisis Support Key Responsibilities: Conduct

assessments and care planning

to support adults with a range of needs. Provide

safeguarding support , managing risk and ensuring compliance with legal frameworks. Work with individuals to promote

independence, well-being, and positive outcomes . Collaborate with

multi-agency teams , including health professionals, housing, and legal services. Maintain

accurate case records

and contribute to service improvements. Requirements: Degree in Social Work

(or equivalent qualification). Registered with Social Work England (or relevant body) . Experience in

at least one

of the following areas:

Learning Disabilities, Safeguarding, Mental Health, Forensic, or Crisis Intervention . Strong understanding of

relevant legislation

(Care Act, Mental Capacity Act, Mental Health Act). Ability to

work independently and within a team . A flexible and proactive approach to work. Why Work with Sensible Staffing? Competitive pay rates

and flexible working arrangements. Opportunities to

gain experience across multiple specialisms . Ongoing support

from a dedicated recruitment consultant. Access to

exclusive job opportunities

across local authorities and NHS trusts. If you are applying for the first time, please complete all fields below Already registered with Sensible Staffing? Just enter your name, contact number and email.

#J-18808-Ljbffr

sector:

sub-sector: Mental Health

type: Temporary

location: South West

Are you a Mental Health Social Worker looking for flexible temporary work?

Sensible Staffing is currently recruiting Mental Health Social Workers to work across a variety of settings, including:
NHS Mental Health Services
Private Hospitals
Local Councils
Community-Based Mental Health Services
Other Specialist Providers

We welcome applications from social workers with experience in at least one of these settings who are eager to expand their skills across different areas of mental health support.

Key Responsibilities:

• Conduct mental health assessments and develop care plans in line with individual needs.
• Work with service users experiencing a range of mental health conditions, supporting their recovery and well-being .
• Collaborate with NHS teams, private healthcare providers, social services, and voluntary organizations .
• Provide safeguarding support and risk management for vulnerable individuals.
• Support hospital discharge planning, crisis intervention, and community reintegration.
• Maintain accurate case records and ensure compliance with relevant legislation.

Requirements:

Degree in Social Work (or equivalent qualification).
Registered with Social Work England (or relevant body) .
Experience in at least one of the following areas: NHS, private hospitals, councils, or community-based mental health services .
Knowledge of relevant legislation (Mental Health Act, Care Act, Mental Capacity Act).
Ability to work independently and as part of a multi-disciplinary team .
A compassionate and proactive approach to supporting individuals with mental health needs.

Why Work with Sensible Staffing?

Competitive pay rates and flexible working arrangements.
Opportunities to gain experience across multiple mental health settings .
Ongoing support from a dedicated recruitment consultant.
Access to exclusive job opportunities across the NHS, private sector, and local authorities.

If you are applying for the first time, please complete all fields below

Already registered with Sensible Staffing? Just enter your name, contact number and email.

#J-18808-Ljbffr