Assistant Manager/Manager Claims Control & Specialised Claims Unit

Allianz; Kuala Lumpur; On-site; Confidential; Full time

Job summary

Allianz in Kuala Lumpur is seeking a seasoned Claims Specialist in P&C to strengthen management, market intelligence, and performance monitoring within the claims team.

The role focuses on reducing leakage through process improvements, fraud detection, and adherence to policy guidelines, while coordinating with Adjusters and ensuring timely settlement.

Qualifications

• Minimum 5 years’ experience in P&C claim handling.
• Strong knowledge of claims processes and policy conditions.
• Experience using AI tools to streamline tasks.

Responsibilities

• Regular review of open claims to reduce leakage through process improvements.
• Manage specialised claims from notification to settlement and oversee Adjusters investigations.
• Monitor outstanding claims with Adjusters.
• Suggest improvements to claim guidelines and processes.
• Assist in department administrative tasks and systems for smooth operations.
• Investigate potential fraud cases to identify patterns and involved parties.
• Develop claim reviews plans for outstanding and closed cases.
• Review complex claims to ensure policy compliance and smooth settlement.
• Maintain up-to-date knowledge of fraud trends in the market.
• Backup team members and cover duties as needed.
• Perform other duties as delegated by management.
• Ensure compliance with policies and regulations.

Skills

Communication skills

AI tools like ChatGPT

Claims processes knowledge

Decision making

Education

Bachelor's degree or equivalent in related field, or Associated MII/CII

Tools

ChatGPT

Job description

Job Summary

• Management and administration.
• Market intelligence.
• Claims Specialist.
• Performance Management.
• Fraud management.

Key Responsibilities

• Regular review of open files in order to identify root causes of claims leakage and the translation of those findings into action plans to reduce leakage through process improvements and/or training.
• To manage the specialised claims from point of notification up to settlement i.e.manage the progress of Adjusters investigation
• Periodic monitoring outstanding claim files with Adjusters.
• Review work processes and provide solutions in improvement of claim guidelines and work processes.
• To assist in department’s administrative works, systems and procedures for smooth operations and continuous improvement.
• Performs investigation of potential fraud cases to uncover the fraud pattern and also the parties involved.
• Developing claim reviews plans (including outstanding and closed cases).
• Review, investigate and actively involved in all complex and contentious claims referred to the team to ensure compliance with policy requirements and smooth settlement.
• Analyses and maintains an up-to-date knowledge and data of fraud trends in the market.
• Backup team members and assume the responsibilities as and when required.
• Perform other duties as delegates by the Management.
• Ensure compliance to policies, guidelines and regulations

Key Requirements

• Bachelors’ Degree or equivalent, in any related field / Associated MII / CII.
• Minimum 5 years’ experience in P&C claim handling.
• Well verse with claims processes and handling.
• Good policy understanding in terms of the policy conditions, exclusions etc.
• Good judgement and able to make decision.
• Good communication skills
• Familiar with the use of AI tools such as ChatGPT for tasks simplification