Assistant Manager/Senior Executive, Claims

Hong Leong Assurance Berhad; Petaling Jaya; On-site; MYR 150,000 - 200,000; Full time

Job summary

A leading insurance company in Malaysia is seeking a Claims Assessor to review and process claims. The ideal candidate will have at least 3 years of experience in claim assessment within the life insurance industry, along with strong interpersonal and customer service skills. This role involves ensuring compliance with policies and enhancing departmental efficiencies.

Qualifications

• Minimum 3 years in claim assessment in life insurance; 5 years for Assistant Manager level with at least 2 years supervisory experience.
• Good knowledge of medical guidelines, Insurance Guidelines, and Insurance Act.

Responsibilities

• Process and review claim cases within specified authority limit.
• Resolve issues through established processes.
• Monitor productivity and Service Level Agreements.

Skills

Claim assessment skills

Interpersonal skills

Customer service skills

Ability to work under pressure

Education

Bachelor's Degree in Medical Science, Nursing, Biology or equivalent

Job description

Process and review claim cases within specified authority limit and TAT.

Attend to claim enquiries, appeals and complaints from internal and external parties (e.g. OFS, BNM or Third Party Administrator) and constantly follow up for pending cases.

Ensure that issues highlighted are resolved effectively and promptly through the established departmental processes and procedures.

Perform investigation on potential fraudulent claims or suspicious cases.

Monitor and ensure that productivity and Service Level Agreement are met within the team.

Assist in preparing monthly reports and maintain documentation of processes.

Participate in process improvement project initiatives to improve efficiency and productivity of the department.

Backup team members and assume the responsibilities as and when required.

Ensure compliance to policies, guidelines and regulations.

Perform other duties as delegated by the Management.

Requirements

Candidate must possess at least a Bachelor's Degree in Medical Science, Nursing, Biology or equivalent.

Minimum 3 years of claim assessment skills in life insurance industry; Assistant Manager level at least 5 years experience with at least 2 years of supervisory experience.

Good knowledge of general medical knowledge, understanding and application of Insurance Guidelines and Insurance Act.

Demonstrate good interpersonal skills, customer service skills, and ability to work under pressure.

Application Questions

• Do you have customer service experience?
• Which of the following statements best describes your right to work in Malaysia?
• What's your expected monthly basic salary?
• Which of the following types of qualifications do you have?
• How many years' experience do you have as an Assistant Manager?
• How many years' experience do you have in the insurance industry?
• How many years' experience do you have as a claims assessor?

About the Company

Hong Leong Assurance Berhad (HLA) is one of the largest insurance companies in Malaysia, offering financial planning and protection solutions to meet the diverse needs of Malaysians at various life cycles. The company operates through a large network of branches, agents and brokers nationwide, providing a high level of customer service.