Non-Medical Claims, Consultant

AIA Digital+; Kuala Lumpur; On-site; MYR 90,000 - 130,000; Full time

Job summary

AIA Digital+ in Kuala Lumpur is seeking an experienced Claims Specialist to process major claims (e.g., Critical Illness, Disability, Death) and ensure timely settlement within established guidelines.

You will manage pending cases, monitor OPAT savings, maintain productivity and accuracy, and communicate with stakeholders promptly. The role requires a Bachelor’s degree and at least 5 years in insurance, with bilingual English and Malay.

Qualifications

• Bachelor’s degree holder or equivalent.
• Minimum 5 years working experience in insurance industry.
• Independent and self-starter.
• Customer service oriented, positive attitude and good interpersonal skills
• Spoken and written in both English and Malay language.
• Good Knowledge in claims assessments, FSA 2013 and technical skills.

Responsibilities

• Major Claims Processing: Handle and settle major claims within the agreed turnaround time and guidelines.
• Pending Case Management: Review all pending cases monthly and reduce pending ratio.
• OPAT Savings: Monitor closed file reviews and ensure timely reversals to achieve savings.
• Productivity & Accuracy: Meet claims productivity benchmarks within authority limits with high accuracy.
• Stakeholder Communication: Respond promptly to enquiries, calls, and emails within two business days.
• Suspense Case Management: Clear suspense cases within five days from receipt of email.
• Additional Duties: Perform other responsibilities and projects as assigned by the supervisor.

Skills

Customer service

Communication skills

Bilingual English & Malay

Claims assessment knowledge

Education

Bachelor's degree

Job description

At AIA we’ve started an exciting movement to create a healthier, more sustainable future for everyone.

It’s about finding new ways to not only better people’s lives, but to better the communities and environments we live in. Encompassing our ambition of helping a billion people live Healthier, Longer, Better Lives by 2030.

And to get there, we need ambitious people who believe in playing an important part in shaping that future. People seeking unmatched career and personal growth opportunities, who are driven to work with, and learn from some of the most inspiring and supportive leaders in the business.

Sound like you? Then read on.

About the Role

Process incontestable and contestable major claims (e.g. Critical Illness, Total and Permanent Disability, Dismemberment, Death claims)

Roles and Responsibilities:

• Major Claims Processing: Handle and settle both incontestable and contestable major claims (e.g., Critical Illness, Total and Permanent Disability, Dismemberment, Death) within the agreed turnaround time (TAT) and in compliance with established procedures and guidelines.
• Pending Case Management: Review all pending cases monthly and work towards reducing the pending ratio in line with agreed targets.
• OPAT Savings: Monitor closed file reviews and ensure timely provision reversals to achieve operational savings.
• Productivity & Accuracy: Meet claims productivity benchmarks within authority limits, delivering work with high accuracy and efficiency.
• Stakeholder Communication: Respond promptly to enquiries, calls, and emails from relevant stakeholders—within two (2) business days.
• Suspense Case Management: Clear suspense cases within five (5) days from the date the email is received.
• Additional Duties: Perform other responsibilities, projects, and special assignments as periodically assigned by the supervisor to meet operational or organizational requirements.

Minimum Job Requirements:

• Bachelor’s degree holder or equivalent.
• Minimum 5 years working experience in insurance industry.
• Independent and self-starter.
• Customer service oriented, positive attitude and good interpersonal skills
• Spoken and written in both English and Malay language.
• Good Knowledge in claims assessments, FSA 2013 and technical skills.

Build a career with us as we help our customers and the community live Healthier, Longer, Better Lives.

You must provide all requested information, including Personal Data, to be considered for this career opportunity. Failure to provide such information may influence the processing and outcome of your application. You are responsible for ensuring that the information you submit is accurate and up-to-date.