Job Description - Assistant Manager, Group B40 Claims (GETB) (240001TR)
Job Number:
240001TR
Job Purpose
Responsible for leading the Critical Illness claims section. This role ensures that the SLA of claims processing is met and properly executed according to SOP & guidelines. You are also responsible for assisting the supervisor in claims management, including TPA monitoring.
The Job
- Monitor and ensure claims are assessed and processed fairly and promptly by the claims team and TPA, both meeting SLA (including TAT, productivity, quality, aging, etc.)
- Ensure all claims processes comply with policy annexure, regulations, and SOP guidelines (including Bank Negara Malaysia, Malaysian Takaful Association, Ombudsman for Financial Services, etc.)
- Support and respond to internal and external stakeholders in a timely manner (including internal teams, hospitals, members, third-party administrators, auditors, etc.)
- Carry out all management support tasks assigned, completed accurately and within deadlines set by stakeholders and management
- Prepare reports as assigned, including management reports, periodic team performance, and productivity reports
- Guide subordinates towards personal development
- Enhance the competency of subordinates in meeting SLA requirements
- Prepare and update claims guidelines
- Act as liaison with TPA team for continuous improvement
- Participate in product briefings or discussions
- Participate in projects, initiatives, assignments, and ad-hoc tasks assigned by superiors
Our Requirements
- Tertiary qualification preferably in science, biomedical science, or medical field, with insurance or takaful qualification as an added advantage
- At least 3 years of experience in Medical, Takaful, or Life Insurance claims department
- Possess leadership qualities, results-driven, and a positive working attitude
- Analytical with the ability to see the overall picture and work independently
- Sense of urgency and business acumen
- Team player
- Good communication skills, both verbal and non-verbal