Claims Management Associate - Analyst

Accenture; Subang Jaya; On-site; MYR 45,000 - 78,000; Full time

Job summary

Accenture Malaysia seeks a claims handling specialist to manage inbound and outbound calls from Insurance Agents and Customers regarding claims, policy inquiries and complaints. You will review policy benefits, check claim status and adjudicate claims with data-driven assessment.

The role covers data collection, analysis, negotiations, and settlement per policy provisions, handling typical liability and low-complexity disputes while maintaining service standards and collaboration with internal

Qualifications

• Ability to prioritize and multitask effectively in a fast-paced environment.
• Good relationship building skills (internal, external, and cross-cultural).
• Ability to communicate information clearly and concisely both verbally and in writing.
• Requires proficiency in Desk Management, phone etiquette, time management and dealing with difficult customers.
• Advance skills and experience in Customer Service and/or Personal Accident Claims Processing may be advantageous.

Responsibilities

• Utilize advanced communication, comprehension and customer service skills to handle Customer/Agent requests and inquiries.
• Utilize acceptable investigation claims handling and settlement techniques that achieve cost effective and timely closure results by obtaining, reviewing and analyzing documentation, policy provisions and other records.
• Ensure proper follow up on cases to resolve outstanding issues and to ensure timely processing and closure of claim
• Provide timely service throughout the life of the claim by meeting all service level agreements, initiating timely contact to all appropriate parties, responding to incoming inquiries according to company policies, following agreed processes to ensure quality and service standards.
• Maintain accurate system data and documentation by collecting, recording, analyzing, and summarizing information.
• Ensure that reserves are accurately updated in a timely manner.
• Identify subrogation opportunities and fraud potential and make referrals
• Provide mentorship to less tenured examiners
• Deputy/Backup Team Leader for governance, practice and execution in the team.

Skills

Multitasking

Communication skills

Customer service

Relationship building

Documentation and data entry

Education

Insurance qualifications (General/Health)

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.

Responsibility

Job Summary

The primary purpose of the job is to handle inbound and outbound calls from Insurance Agents and Customers to answer questions/ or attend to requests on but not limited to claim, policy inquiries, and handling complaints and irate customers etc. During call handling, he/she is required to check status of claims, review policy benefits and advise customers accordingly.

Apart from voice work, he/she will also be required to register and adjudicate claims which involve investigation, evaluation, negotiation and settlement. This is done by collecting and analyzing data according to policy application and/or contract provisions. Determine whether to accept or deny a claim based on all documentation received. Typical claims include liability and low complexity coverage issue disputes.

Job Descriptions:

• Utilize advanced communication, comprehension and customer service skills to handle Customer/Agent requests and inquiries.
• Utilize acceptable investigation claims handling and settlement techniques that achieve cost effective and timely closure results by obtaining, reviewing and analyzing documentation, policy provisions and other records. May require additional contact with other parties i.e. employer, claimants, third parties such as medical providers, auto repair centers, etc. as deemed necessary
• Ensure proper follow up on cases to resolve outstanding issues and to ensure timely processing and closure of claim
• Provide timely service throughout the life of the claim by meeting all service level agreements, initiating timely contact to all appropriate parties, responding to incoming inquires according to company policies, following agreed internal and external processes, policies and procedures to ensure quality and service standards are met. This includes all forms of communications to internal and external parties
• Maintain accurate system data and documentation by collecting, recording, analyzing, and summarizing information
• Ensure that reserves are accurately updated in a timely manner
• Identify subrogation opportunities and fraud potential and make appropriate referrals
• Provide mentorship to less tenured examiners
• Deputy/Backup Team Leader for all matters pertaining to operational governance, practice and execution in the team. Advocate of process & people management, operational excellence, metrics & management information, risk & compliance

Job Requirement/Qualifications:

• Certified in Singapore College of Insurance - General Insurance and/or Health Insurance and/or Professional Qualification in Malaysian Insurance Institute - Certificate of Insurance Practice/Diploma in Insurance/AMII/FMII
• Ability to prioritize and multitask effectively in a fast-paced environment
• Good relationship building skills (internal, external, and cross - cultural)
• Ability to communicate information clearly and concisely both verbally and in writing
• Requires proficiency in Desk Management, phone 'etiquette', time management and dealing with difficult customers
• Advance skills and experience in field of Customer Service (required) and/or Personal Accident Claims Processing (advantage)
• Communication skills and interpersonal skills will be an advantage
• Ability to document work in progress in accordance with applicable procedures will be an advantage
• Working Hours: Monday - Friday 8.30 AM - 5.30 PM