PBTB | Assistant Manager, Fraud Waste and Abuse Management
Prudential · Kuala Lumpur (Takaful)
Full-timeonsitemidOtherHealthcare
รายละเอียดงาน / Description
Based in Malaysia, this role involves providing essential medical support across various company functions, with a focus on fraud, waste, and abuse management within the takaful sector. The position requires contributing medical expertise to complex cases, product development, and health awareness initiatives. You will also be responsible for reviewing and updating claims and underwriting guidelines, conducting quality audits, and driving cost containment efforts.
หน้าที่ความรับผิดชอบ / Responsibilities
- Provide medical input for complex cases and referrals to assessors
- Offer medical expertise to departments like Product Development and Health Awareness
- Review and update claims and underwriting guidelines to meet industry standards
- Assess new medical technologies and procedures
- Conduct audits to evaluate operational technical capabilities and quality
- Identify claims leakages and prevent fraud, waste, and abuse
ทักษะที่ต้องการ / Required skills
- Medical Expertise
- Claims Management
- Underwriting Guidelines
- Fraud Detection
- Waste Management
- Abuse Prevention
- Cost Containment
- Medical Quality Review
- Regulatory Compliance