Claims Resolution & Settlement Specialist

Accenture PLC; Subang Jaya; On-site; MYR 45,000 - 73,000; Full time

Job summary

Accenture PLC in Malaysia is seeking a Claims Handler to manage inbound/outbound calls from Insurance Agents and Customers, addressing inquiries on claims and policies. Responsibilities include registration and adjudication of claims, investigation, evaluation and settlement, and ensuring timely closure with proper data documentation.

Role requires strong communication, multitasking, and adherence to service levels.

Qualifications

• Able to prioritize and multitask effectively in a fast-paced environment.
• Strong communication, both verbal and written.
• Excellent relationship-building with internal and external parties.
• Proficient in desk management and telephone etiquette.
• Experience in customer service and claims processing is a plus.
• Working hours: Monday–Friday 8:30 AM–5:30 PM.

Responsibilities

• Handle inbound and outbound calls from Insurance Agents and Customers to answer questions or attend requests regarding claims and policies.
• Register and adjudicate claims, including investigation, evaluation, negotiation and settlement.
• Collect, analyze data to determine claim acceptance or denial.
• Maintain accurate system data and documentation.
• Identify potential subrogation opportunities and fraud; refer as appropriate.
• Provide mentorship to less tenured examiners.
• Deputy/Backup Team Leader for governance, process and execution within the team.

Skills

Prioritization & multitasking

Customer service

Communication skills

Relationship building

Time management

Handling difficult customers

Education

Singapore College of Insurance - General Insurance and/or Health Insurance and Malaysian Insurance Institute qualifications

Job description

Accenture PLC in Malaysia is seeking a Claims Handler to manage inbound/outbound calls from Insurance Agents and Customers, addressing inquiries on claims and policies. Responsibilities include registration and adjudication of claims, investigation, evaluation and settlement, and ensuring timely closure with proper data documentation.

Role requires strong communication, multitasking, and adherence to service levels.