[MY] Executive / Senior Executive, Outpatient Claims

Operations · Petaling Jaya, Selangor
Department Operations
Employment Type Full-Time
Minimum Experience Experienced

About the team

Doctor Anywhere's Operations team is a crucial part of the company. We ensure the day-to-day excellence of our TPA business, virtual and in-person clinical services, resolving operational issues in a timely manner and providing the best customer experience possible. We make sure that our customers remain our top priority.

About the role

We are seeking an Outpatient Claims Executive who will provide accurate adjudication of Health insurance claims submitted by our clients. The ideal candidate will have a mindset of continuous improvement and change and will demonstrate curiosity, collaboration and the ability to deal with ambiguity especially in a start-up environment. This role reports directly to the Manager, Medical Claims. 

A summary of the key responsibilities and requirements are as follows:

  • Proactive management of claims, timely processing & claim administration within stipulated turnaround time (TAT)
  • Adjudicate outpatient claims and decide on claim settlements and approve within authority limit
  • Ensure all queries are responded to in a timely manner with continuous communication with both internal and external customers and providing the required support with the objective of providing a quality claim service experience.
  • Work and maintain positive relationships with customers / corporate clients for any claims-related matters
  • Assist in providing necessary information and ad-hoc assignment to Manager to allow for accurate and timely submission of reports to management as well as maintaining the records, reports and claims file
  • Investigate and escalate technical claim issue as and when experienced
  • Other ad-hoc duties as assigned

About you 

  • Diploma/Degree in any discipline with minimally 3 years of assessing claims in Insurance/ Medical Assistance/ TPA experience.
  • CGI and Health Insurance certification preferred but not mandatory
  • Computer literate
  • Self-motivated individual with a strong sense of responsibility
  • Resourceful with strong problem-solving skill
  • Good team player and service-oriented

About Doctor Anywhere

Doctor Anywhere (DA) is on a mission to be the largest tech-enabled, omnichannel healthcare provider in Southeast Asia. First launched in Singapore in 2017, DA aims to bridge gaps in the healthcare ecosystem through developing innovative solutions and technologies. In 2021, DA raised SGD$88 million in Series C fundraising (August 2021) and acquired Doctor Raksa, the biggest telemedicine platform in Thailand which further strengthened our foundation for telehealth and healthcare offerings. Today, DA is present in Malaysia, Thailand, the Philippines, Vietnam, Indonesia and India, serving more than 2.5 million (and growing) users across the region.

At DA, we believe in the value of innovation and collaboration. Grounded in our motto of “Keep Going, Keep Growing”, our team strives towards excellence every day, and values diversity in perspectives brought by every member. Together, we bring quality healthcare to your doorstep!


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  • Location
    Petaling Jaya, Selangor
  • Department
  • Employment Type
  • Minimum Experience