Role Summary
The Executive, Claims is responsible for adjudicating Accident & Health (A&H) claims. This role involves managing investigations and ensuring equitable decisions within service level agreements to enhance customer experience.
Job Description
As an Executive in Claims, you will engage in daily interactions with claimants, medical institutions, and financial consultants to process claims efficiently. You will be part of a dynamic team focused on delivering high-quality service and maintaining accuracy in claims processing.
Key Responsibilities:
- Adjudicate Accident & Health claims to ensure compliance with service level agreements.
- Manage investigations by coordinating with claimants and medical institutions.
- Follow up on outstanding requirements to expedite claims processing.
- Address enquiries and appeals from claimants effectively.
- Collaborate with business units to optimize processing accuracy.
- Maintain detailed records of claims and investigations.
- Provide support and guidance to team members as needed.
Job Requirements
At least 1-2 years of experience as a Life & Health claims assessor.
Strong command of the English language; basic Chinese is advantageous.
Proficiency in medical knowledge and claims settlement procedures.
Excellent communication, interpersonal, and problem-solving skills.
Ability to investigate, evaluate, and reach appropriate decisions independently.
Quick Info
Company
—
Location
Kuala Lumpur
Salary
Undisclosed
Incentive / Bonus
Not specified
Skills Required
7 skills
Click to submit your application
Required Skills
Claims Adjudication
Investigation
Communication
Problem-Solving
Customer Service
Team Collaboration
Attention To Detail
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