Assistant Manager/Senior Executive, Claims

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

Job summary

A prominent insurance company based in Petaling Jaya is seeking a dedicated Claims Assessor with a Bachelor's degree in Medical Science, Nursing, or Biology. The successful candidate will have at least 3 years of relevant experience in the life insurance sector and exhibit strong customer service skills along with the ability to manage claims and oversee compliance. This role encourages teamwork and process improvement to enhance operational efficiency.

Qualifications

• Minimum 3 years of claim assessment experience in the life insurance industry, with at least 2 years in a supervisory role.
• Good knowledge of general medical knowledge and Insurance Guidelines.
• Demonstrated ability to solve customer service issues effectively.

Responsibilities

• Review and process claim cases within set authority limits.
• Respond to claims enquiries and follow up on pending cases.
• Conduct investigations on potential fraudulent claims.
• Ensure compliance with corporate policies and regulations.

Skills

Claims assessment

Interpersonal skills

Customer service skills

Ability to work under pressure

Education

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

Job description

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Responsibilities

• 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 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 responsibilities as and when required.
• Ensure compliance with 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 with at least 5 years experience, including 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?