Insurance Executive / Claims Executive

Jobstreet Malaysia; Johor Bahru; On-site; MYR 33,000 - 67,000; Full time

Job summary

Jora Malaysia is seeking a Claims Executive to manage a portfolio of insurance claims from registration to final settlement, ensuring compliance and timely processing.

You will liaise with clients, insurers, loss adjusters, and providers, maintain records, generate reports, and support data automation while upholding PDPA confidentiality.

Responsibilities

• Manage and administer claims throughout the full lifecycle, from registration to final settlement
• Ensure all claims are registered with insurers promptly (within 24 hours) and followed through to timely settlement, including payout processing
• Prepare, review, and submit claim forms and supporting documentation, ensuring completeness and compliance with policy terms and requirements
• Verify and validate claims submissions, including assessing straightforward personal and non-complex commercial insurance claims
• Update and maintain claims status in internal systems and platforms
• Liaise with clients, insurers, loss adjusters, lawyers, clinics/hospitals, and third-party administrators to facilitate fair and timely claim outcomes
• Act as the main point of contact for clients, handling enquiries on claims, insurance coverage, and pre-authorisation via phone and email
• Communicate claim outcomes clearly to clients, including explanations of settlement decisions
• Verify applicant eligibility against policy or grant criteria and notify applicants of incomplete or unsuccessful submissions
• Monitor and follow up on outstanding claims, documentation, and settlement matters
• Maintain accurate and organized documentation, including proper electronic and physical filing of claims records
• Prepare regular claims reports, including activity reports, bordereaux, claims logs, and analysis
• Support claims data preparation, reporting, and automation/testing initiatives
• Provide general administrative and operational support to the Claims Team, including report preparation and documentation
• Ensure compliance with regulatory requirements, company policies, and guidelines, including PDPA and confidentiality standards

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.

The Claims Executive is responsible for managing a portfolio of clients and supporting the end-to-end claims process for General and Health Insurance products. This role ensures accurate, timely, and compliant claims handling while delivering strong client service and operational support.

Manage and administer claims throughout the full lifecycle, from registration to final settlement

Ensure all claims are registered with insurers promptly (within 24 hours) and followed through to timely settlement, including payout processing

Prepare, review, and submit claim forms and supporting documentation, ensuring completeness and compliance with policy terms and requirements

Verify and validate claims submissions, including assessing straightforward personal and non-complex commercial insurance claims

Update and maintain claims status in internal systems and platforms

Liaise with clients, insurers, loss adjusters, lawyers, clinics/hospitals, and third-party administrators to facilitate fair and timely claim outcomes

Act as the main point of contact for clients, handling enquiries on claims, insurance coverage, and pre-authorisation via phone and email

Communicate claim outcomes clearly to clients, including explanations of settlement decisions

Verify applicant eligibility against policy or grant criteria and notify applicants of incomplete or unsuccessful submissions

Monitor and follow up on outstanding claims, documentation, and settlement matters

Maintain accurate and organized documentation, including proper electronic and physical filing of claims records

Prepare regular claims reports, including activity reports, bordereaux, claims logs, and analysis

Support claims data preparation, reporting, and automation/testing initiatives

Provide general administrative and operational support to the Claims Team, including report preparation and documentation

Ensure compliance with regulatory requirements, company policies, and guidelines, including PDPA and confidentiality standards