Assistant Manager, Claims (GETB)

Great Eastern; Kuala Lumpur; On-site; MYR 60,000 - 80,000; Full time

Job summary

A leading insurance company is seeking a candidate to lead the medical claims section in Kuala Lumpur. This role involves managing the assessment and processing of healthcare claims, ensuring compliance with regulations, and coordinating with various stakeholders. Applicants should have a tertiary qualification and at least 4 years of experience in the insurance claims department. Ideal candidates will demonstrate strong communication skills, a positive work attitude, and the ability to work both independently and as part of a team.

Qualifications

• Experience of at least 4 years in Takaful or Life Insurance company's Claims Department.
• Capable of performing claim investigations as needed.
• High level of integrity and accountability.

Responsibilities

• Lead the medical claims section to ensure timely claims processing.
• Audit, track and monitor quality of work within the section.
• Support Customer Service and respond to stakeholders promptly.

Skills

Good communication skills

Ability to work independently

Positive working attitude

Team collaboration

Sense of urgency

Education

Tertiary qualification in science, biomedical science, or mathematics

Insurance or takaful qualification

Job description

You are responsible to lead the medical claims section. The role involves in ensuring claims assessment and processing of healthcare/ medical claims, namely hospitalization, hospital benefit claims, etc are properly done and according to the SOP & guidelines. You are also responsible to assist supervisor for claims functions and implement Operations’ & claims strategy to support the company’s goal and performance

Job Description:

• To ensure claims are assessed and processed fairly and timely
• To ensure all claims processes are complied with all rules and regulation and governance from regulators, MTA, company’s policy and guideline
• To ensure claims are settled and processed within the agreed TAT
• To support and respond to Customer Service, Third Party Administrator, Outsourcing parties, clients (internal & external) and agents on timely manner
• To audit, track and monitor quality of work within the section
• To ensure reports are prepared with quality output in agreed timeline
• To monitor the works of Third-Party Administrator or outsourced organization, if any, and oversee their performance.
• To be able to perform claim investigation if required
• To participate in any product briefing or discussion if required
• To participate in projects, meetings, external claim training, roadshows, UAT, ORT, initiatives and any other tasks assigned by superior.

Our Requirements:

• Tertiary qualification in preferably in science, biomedical science, mathematics, and with insurance or takaful qualification as added advantage
• Experience of at least 4 years in Takaful or Life Insurance company’s Claims Department
• Good & positive working attitude and habits.
• Able to work independently and a self-starter.
• Have sense of urgency and no procrastinating
• Able to work as a team
• Possess good communication skills, verbal & non-verbal.
• High level of integrity, takes accountability of work and good attitude over teamwork.
• Takes initiative to improve current state of things and adaptable to embrace new changes.

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