Manager, Claims

Hong Leong Assurance; Selangor; On-site; MYR 80,000 - 110,000; Full time

Job summary

A financial services company based in Malaysia is seeking a highly motivated individual for a Claims Management role. The ideal candidate should possess at least 5 years of experience in claim assessment, particularly in Life or Medical Insurance. Responsibilities include verifying claims, monitoring performance metrics, and conducting training. A degree in a relevant field is essential, and mastery of Microsoft Office applications is required. This position demands proactive behavior and a keen understanding of insurance guidelines.

Qualifications

• Degree related to Life Insurance, Science, Law or Equivalent.
• 5+ years experience in claims management of Life/Takaful insurance.
• Advanced claim assessment skills on Life or Medical Insurance.

Responsibilities

• Verify and process claims according to policies.
• Monitor performance metrics for team productivity.
• Conduct User Acceptance Testing for system upgrades.

Skills

Claim assessment

Proactive behavior

Team management

Knowledge of insurance guidelines

Communication skills

Education

Degree in Life Insurance, Science, Law, or Equivalent

Masters degree or Professional qualification (e.g. LOMA)

Tools

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

Job description

We are seeking a highly motivated and detail-oriented individual to join our Claims Department. The ideal candidate will be responsible for the end-to-end management of claims, ensuring accuracy, efficiency, and adherence to regulatory and internal standards.

Job Responsibilities

• Verify, approve, and process claims cases in strict accordance with guidelines, policies and procedures.
• Follow-up and sending timely reminders for all pending cases to ensure prompt resolution.
• Ensure all transactions, including CSIU, OPS and BNM cases are completed within the defined Service Level Agreements (SLA).
• Handle and resolve claim enquiries from internal and external stakeholders.
• Monitor individual and team performance metrics to ensure productivity targets and Service Level Agreements (SLAs) are consistently met.
• Review and update claim guidelines and procedures to reflect current regulatory requirements and best practices.
• Review key documentation, including contract, reinsurance treaty and letter template.
• Highlight trends or breakdowns in existing processes to management for continuous improvement.
• Conduct System User Acceptance Testing (UAT) for system upgrades or enhancements to ensure functionality meets business requirements.
• Provide coaching, training, and performance appraisal support for new recruits and direct reports.
• Participate in non-system ad-hoc projects as delegated by the supervisor or management.
• Perform other related duties and administrative functions as required by Management.

Job Requirements

• Degree related to Life Insurance, Science, Law or Equivalent. Masters degree or Professional qualification (e.g. LOMA) is desired.
• At least 5 years working experience in claims assessment/management of Life/Takaful insurance, Critical Illness, Accidental and Medical related products.
• Advanced claim assessment skill on Life or Medical Insurance. General medical knowledge. Intermediate understanding and application of insurance guidelines and insurance act.
• At least 1 year of supervisory experience.
• Familiar with Microsoft Office applications (e.g. Words, Excel and PowerPoint).
• Proactive, agile and responsible behaviour.