Major Claims Specialist – Death & Critical Illness

AIA Shared Services; Cyberjaya; On-site; MYR 70,000 - 110,000; Full time

Job summary

AIA Shared Services in Malaysia is seeking a Major Claims Assessor to review and process claims accurately, including death and critical illness cases. You will use digital tools and collaborate with Medical Advisors to ensure sound decisions and timely payments.

The role requires a biomedical-related education, at least 2 years in Major Claims, and strong English writing and communication skills. A background in life insurance is a plus, with a focus on customer-driven problem solving.

Qualifications

• Bachelor level qualification in Biomedical, Biology, Medicine, Nursing or related fields.
• Minimum 2 years Major Claims experience (death, critical illness and/or total permanent disability).
• Life insurance experience is an advantage.
• Strong English writing skills and clear communication are required.
• Self-motivated and customer-driven with good problem-solving ability.

Responsibilities

• Review claims documentation, policy coverage, medical evidence, and loss details to determine claim validity and entitlement.
• Assess, review, investigate, approve and process Major Claims accurately and timely.
• Utilize digital claims systems, workflow tools, and data dashboards to monitor turnaround time and quality.
• Leverage automation and AI-enabled tools to improve assessment efficiency and accuracy.
• Liaise with Medical Advisors for clinical guidance on complex claims.
• Perform suspense management and coordinate with Finance for timely claim payments.
• Discuss and document complex claims with senior assessors for guidance and resolution.
• Identify operational inefficiencies and contribute to process improvements.
• Support innovation initiatives and knowledge sharing within the team.
• Perform other duties as assigned to meet business needs.

Skills

English writing

Communication

Problem solving

Customer focus

Education

Biomedical, Biology, Medicine, Nursing or related fields

Job description

AIA Shared Services in Malaysia is seeking a Major Claims Assessor to review and process claims accurately, including death and critical illness cases. You will use digital tools and collaborate with Medical Advisors to ensure sound decisions and timely payments.

The role requires a biomedical-related education, at least 2 years in Major Claims, and strong English writing and communication skills. A background in life insurance is a plus, with a focus on customer-driven problem solving.