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

AIA Shared Services; Sepang; On-site; MYR 60,000 - 80,000; Full time

Job summary

A financial services company is seeking a Major Claims Specialist, responsible for processing major claims in line with company standards. The role includes training new staff on claims assessment and ensuring quality benchmarks are met. Candidates must have a minimum of 3 years of experience in major claims, along with relevant educational qualifications in biomedical or related fields. Experience in life insurance is a plus. The company will relocate to IOI Tower 1, Putrajaya in 2026.

Qualifications

• Minimum 3 years Major Claims experience (death, critical illness and/or total permanent disability).
• Experience in Life insurance is an advantage.
• Self-motivated and customer-driven.

Responsibilities

• Provide high-quality claims services for Major Claims.
• Train new joiners on product knowledge and claims assessment skills.
• Assist in data analysis for reporting and trend analysis.

Skills

Customer service orientation

Problem solving skills

Education

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

Job description

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

Provides high-quality claims services in authorized claims transactions for Major Claims (Death, Critical Illness, Total or Partial Permanent Disability 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

Self-motivated and customer-driven

Sound problem solving skill

We will be relocating from Cyberjaya to IOI Tower 1, Putrajaya in 2026.