Major Claims Specialist (Death, Critical Illness and/or TPD)

AIA Shared Services; Cyberjaya; On-site; MYR 100,000 - 150,000; Full time

Job summary

A leading insurance provider in Cyberjaya is seeking a Claims Assessor for Major Claims. The role involves high-quality processing of claims related to death, critical illness, and permanent disability. Candidates should have at least 3 years of Major Claims experience, preferably in Life insurance. Proficiency in both Chinese and English is preferred. This position offers an opportunity to train new joiners and contribute to data analysis for reporting purposes.

Qualifications

• Minimum 3 years of Major Claims experience including death, critical illness and total permanent disability.
• Experience in Life insurance is an added advantage.
• Skillful in training and coaching new joiners.

Responsibilities

• Process major claims transactions within approval authority.
• Train new joiners on claims assessment skills.
• Assist in data analysis for reporting and trends.

Skills

Communication skills

Problem-solving skills

Customer-driven mindset

Proficiency in Chinese and English

Education

Education in Biomedical, Biology, Medicine, Nursing or related fields

Job description

About the Role

• Provides high-quality claims services in authorized claims transactions for Major Claims (Death, Critical Illness, TPD and Payor Benefit) within the required benchmarks and in line with the Company and department goals.
• Register, reserve, assess, review, investigate, approve and process payment for Major claims within own Claims Approval Authority and recommend to higher level for claims above authority.
• Provide support in building and developing complete skill sets for Major Claims Assessors

Key Responsibilities

Claims Processing

• Register, reserve, assess, review, investigate, approve and process payment for Major claims within Claims Approval Authority and recommend to higher level for claims above authority.
• Ensure meeting individual quality, turnaround time and productivity benchmark

Training

• Train new joiners on product knowledge, claims assessment skills within established standard and guidelines (including Review and Feedback for On-The-Job training cases)
• Provide training / coaching for current and new hires for the use of system and assessment skills, towards certification with Claims Approval Authority, as stipulated in the Claims Approval Authority guidelines.

Ad hoc

• Assist in data analysis for purpose of reporting and trends analysis.
• Performs other responsibilities periodically assigned by immediate manager to meet business requirements

Requirements

• Education qualification in Biomedical, Biology, Medicine, Nursing or related fields
• Minimum 3 years Major Claims experience (death, critical illness and/or total permanent disability)
• Experience in Life insurance will be an added advantage
• Preference for proficiency in both spoken and written Chinese and English, with strong written skills.
• Good communication skill.
• Self-motivated and customer-driven
• Sound problem solving skill