About the job

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.