Major Claims Specialist – Death & Critical Illness

AIA Hong Kong and Macau; Malaysia; On-site; MYR 60,000 - 90,000; Full time

Job summary

AIA Hong Kong and Macau is seeking an experienced Major Claims professional for the Malaysia-based role. You will review and assess major life claims (Death, Critical Illness, TPD), determine liability, and ensure timely, accurate payment decisions using digital claims systems.

The ideal candidate has at least 2 years in Major Claims, strong English writing and communication skills, and a proactive, customer-focused mindset.

Qualifications

• Education in Biomedical/Biology/Medicine/Nursing or related field.
• Minimum 2 years Major Claims experience (death/CI/TPD).
• Strong English writing and good communication skills.
• Self-motivated and customer-driven; strong problem solving.

Responsibilities

• Provide high-quality Major Claims services (Death and Critical Illness) within authority and guidelines.
• Review claims docs, policy coverage, medical evidence, and facts to determine 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 and quality benchmarks.
• Leverage automation and AI-enabled tools to enhance efficiency and accuracy.
• Liaise with Medical Advisors for guidance and supported decisions.
• Manage suspense, follow up on requirements, ensure timely claim payments.
• Suggest process improvements and participate in innovation initiatives.

Skills

English writing

Communication

Customer-driven

Problem solving

Education

Biomedical/Biology/Medicine/Nursing related

Tools

Digital claims systems

Workflow tools

Data dashboards

Job description

AIA Hong Kong and Macau is seeking an experienced Major Claims professional for the Malaysia-based role. You will review and assess major life claims (Death, Critical Illness, TPD), determine liability, and ensure timely, accurate payment decisions using digital claims systems.

The ideal candidate has at least 2 years in Major Claims, strong English writing and communication skills, and a proactive, customer-focused mindset.