Associate, Claims Investigation

Great Eastern; Kuala Lumpur; On-site; MYR 50,000 - 80,000; Full time

Job summary

Jora Malaysia is seeking a Claims Analyst to conduct investigations and substantiate decisions for Life and Health claims. You will review cases, develop investigation plans, and liaise with policyholders to obtain authorisations and declarations.

The role requires a university degree, at least 2 years' claims analysis experience, and good knowledge of the insurance industry. Strong problem solving, communication, integrity, and teamwork are essential.

Qualifications

• University degree required; other professional qualifications advantageous.
• At least 2 years’ claims analysis experience with strong knowledge of the insurance industry.

Responsibilities

• Conduct investigation to substantiate claim decisions for Life and Health claims.
• Review and study cases and develop investigation plans.
• Obtain duly completed Letter of Authorisation/Consent and Letter of Declaration from policyholders.
• Initiate and follow up with clinics/doctors/hospitals to obtain medical history details and completed questionnaires.
• Consolidate investigative findings and prepare recommendations for claim decisions.
• Ensure proper documentation of investigation evidences.
• Process/handle medical report fees due to clinics/doctors/hospitals.

Skills

Problem solving and decision making

Written and verbal communication

Customer oriented

Integrity and trustworthy

Organised and planned

Teamwork and cooperation

Education

University degree in any discipline

Other professional qualification advantageous

Job description

Jora Malaysia will close on 9th September 2026. Thank you for being with us, we are cheering you on as you continue your career journey.

• Conduct investigation to substantiate claim decision for Life and Health claims.
• Review and study cases and develop investigation plan
• Obtain duly completed Letter of Authorisation/Consent and Letter of Declaration from policyholders
• Initiate and follow-up with clinic/doctor/hospital to obtain details of the policyholder's medical history and records, duly completed questionnaires and etc.
• Consolidate investigative findings and prepare recommendation for claim decision making based on feedback/information as a result of investigation.
• Proper documentation of investigation evidences.
• Process/handle medical report fee due to clinic/doctor/hospital
• University Degree in any discipline. Other professional qualification would be an advantage
• At least 2-year experience in claims analysis with a good knowledge of the insurance industry.
• Key Competencies:
  • i) Problem solving and decision making
  • ii) Good written and verbal communication
  • iii) Customer oriented person
  • iv) Integrity and trustworthy
  • v) Organised and proper planned
  • vi) Teamwork and cooperation