Infirmier Coordinateur F/H at Henner

Kuala Lumpur, Kuala Lumpur, Malaysia -

Full Time

Start Date

Immediate

Expiry Date

28 Jun, 26

Salary

0.0

Posted On

30 Mar, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Medical Claim Assessment, Clinical Guidelines, Patient Care Coordination, Medical File Review, Claim Adjudication, Regulatory Compliance, Critical Thinking, Interpersonal Skills, Organizational Skills, Communication, Customer Service, Process Management, Microsoft Office Suite

Industry

Insurance

Description

THE POSITION Our Medical Department is currently recruiting a "Nurse Coordinator W/M" for a permanent position (CDI) at our Kuala Lumpur site. The Nurse Coordinator will serve as a key role for day-to-day medical claim assessment, managing high-value and complex medical claim. This role involves comprehensive medical file review, coordination of patient care, and collaboration with internal and external stakeholders to ensure accurate claim assessment and optimal patient outcomes. If you choose to join us, your main responsabilities will be to: Medical Claim Assessment * Validate medical necessity and treatment plans against evidence-based standards. * Identify potential cost control without compromising patient care. * Prepare clinical summaries and recommendations for claim adjudication. * Ensure documentation meets regulatory and payer requirements. High and Complex Claim * Analyze and review high-cost and complex medical claims for accuracy, appropriateness, and compliance with clinical guidelines. * Assess patient medical records, diagnostic reports, and treatment histories for reporting to the client and insurers. Patient Management & Care Coordination * Act as a liaison between patients, healthcare providers, and various Henner stakeholders (client service team, sales team, etc) * Coordinate care plans for patients with complex medical needs, ensuring continuity and quality of care. * Provide patient support for treatment adherence and recovery. Stakeholder Collaboration * Work closely with admin team, doctors, and managers within the department to resolve discrepancies. * Participate in collective discussions among team on complex cases to enhance knowledge and skills enhancement. YOUR PROFILE You hold a Bachelor’s Degree in Nursing and a Registered Nurse (RN). You have a minimum of 2 to 3 years in clinical experience in the healthcare field, providing you with strong professional and technical expertise. You stand out for your interpersonal and organizational skills, including: * Good knowledge of medical terminology, clinical guidelines, and insurance processes (optional). * Excellent analytical and critical thinking skills. * Effective communication abilities. * High sense of customer service. * Good understanding of process management. * Proficiency in office tools and software (Microsoft Office Suite, etc.) * Strong language proficiency in English. WHY JOIN US ? By joining our teams, you will benefit from training, full support in our jobs and tools, and close management guidance. You will enjoy all the social benefits provided to our employees: meal allowance, 100% coverage of the basic individual or family health insurance, and reimbursement of transport costs. You are guaranteed a good work-life balance thanks to our company agreements and a flexible work organization allowing you to work remotely up to 2 days per week, or even 3 days for people with disabilities, caregivers, or pregnant employees - in accordance with Henner's internal policy. HENNERINT Henner, an international and independent group, creates, manages, and markets innovative solutions in personal insurance. We are 1,850 employees present in 20 countries worldwide. Every day, we support 64,000 client companies and 2.3 million beneficiaries. Our expertise in social protection is summed up in one word: Caring. Caring is much more than an idea. It’s a promise that Henner makes to its clients and partners to carry out its social protection consulting, brokerage, and management services with a constant focus on providing exceptional care and attention to the quality of its support.

Responsibilities

The Nurse Coordinator will primarily assess medical claims for necessity and cost-effectiveness, while also managing high-value and complex cases. This role involves coordinating patient care and acting as a liaison between patients, providers, and internal stakeholders to ensure accurate claim assessment and optimal patient outcomes.