Jawatan Kosong 2023 di Tenaga Nasional Berhad (TNB) | Permohonan adalah dipelawa daripada Warganegara Malaysia yang berkelayakan dan berumur tidak kurang dari 18 tahun pada tarikh tutup iklan ditawarkan untuk memohon jawatan kosong terkini di Tenaga Nasional Berhad
Jawatan:
1. MEDICAL EXECUTIVE (MEDICAL CLAIM MANAGEMENT)
Title
Medical Executive (Medical Claim Management)
Reporting To
Senior Manager (Medical Management)
Mission (Sources of Values)
The Medical Management Team, is a part of TNB HealthCare encompassing claims, administration and medical cost containment, is committed to the principles of service, integrity and professionalism while providing our valued clients (LLN Retirees / TNB employees and their dependents) the highest quality of service with the goal of achieving an effective balance between employee health and financial well-being.
Accountability & Responsibility
• Conduct research on medical information for certain medical conditions, so as to be able to provide detailed and documented evidence for the approval of declined cases.
• Deny all incorrect claims submissions.
• Review medical claims submitted as an appeal.
• Update benefit plans for each contracted medical provider.
• Update current list of medical providers (hospitals and panel clinics).
• Make outgoing phone calls when necessary, to verify or obtain information regarding a claim to ensure timely processing.
• Receive incoming calls from Call Centre, TNB/ LLN clients and providers. Analyse the caller’s needs, research information, answer questions and resolve issues.
• Mentor others on the team and serve as a subject matter expert or contact for specific claims.
• Conduct necessary medical training for operations of the unit which encompasses Call Centre, Claim and Medical Management unit.
• Provide briefing on medical related issues to all staff.
• Verify on-line records. Maintain accurate customer information by making corrections or referring information to appropriate person.
• Participate in auditing medical providers.
• Participate in inspection of TNB Dispensaries.
KPIs
• Medical cost savings initiatives for overall TNB Medical Costs
• Monthly analysis of value creation for Medical Cost Avoidance, and Prolonged stay
• Customer Satisfaction Index (CSI) - Revision of Medical Guidelines
• Value Creation from Interventional Program
End Products
Monthly
• Complete reviewed complex cases for Guarantee Letter (GL)
• Complete reviewed complex cases for claims
• Management report
Quarterly
Survey report on medical compliance
Bi-annually
Report on competency index
Competencies
L1-Vision
L2-Business Acumen
L3-Engaging Others
L4-Self and People Development
L5-Accountability
L6-Result Orientation
F-Application of Internal TNB System
F-Call Centre Management
F-Customer Services Quality Assurance
F-Networking and Interpersonal Skills
F-Database Management
F-Report Management
F-Analytical Skills
Education
Degree in Nursing.
Experience Requirement
Minimum 3 years of clinical nursing experience or working experience in similar capacity.
Networking & Relations
• Medical providers
• Employees & their dependents
• Retirees & their dependents
Tarikh tutup permohonan : 27 September 2023 (Rabu)
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Tenaga Nasional Berhad (disingkatkan sebagai TNB atau didagangkan sebagai Tenaga Nasional; TENA, MYX: 5347) adalah syarikat bekalan elektrik yang terbesar di Malaysia. Aset perniagaannya adalah sejumlah RM 60.0 billion. Bilangan pelanggan adalah lebih 6 juta akaun di Semenanjung Malaysia dan Sabah.
Perniagaannya terasnya ialah menjana, menghantar dan membahagi tenaga elektrik ke seluruh Malaysia. Tenaga Nasional Berhad (TNB) juga adalah pengendali Grid Nasional, iaitu talian penghantar elektrik ke seluruh negara. Talian ini terdiri dari talian 132 kV, 275 kV dan 500 kV.