Lead Specialist & Major Claims

AIA Shared Services; Cyberjaya; On-site; MYR 50,000 - 70,000; Full time

Job summary

A health insurance company in Cyberjaya is seeking a professional for Claims Processing involving Major Claims. Responsibilities include determining claim validity, processing payments, and training new members on claims assessment skills. Candidates should have at least 3 years of Major Claims experience, preferably in Life Insurance, and possess proficiency in both Chinese and English. This role offers a chance to contribute to customer service excellence while building a career in a dynamic environment.

Qualifications

• Minimum 3 years Major Claims experience.
• Experience in Life insurance is an added advantage.
• Self-motivated individual.

Responsibilities

• Determine the validity and authorise settlement of group life insurance claims.
• Train new joiners on product knowledge and claims assessment skills.
• Assist in data analysis for reporting and trends.

Skills

Proficiency in Chinese

Good communication skill

Problem solving skill

Customer-driven

Education

Education qualification in Biomedical, Biology, Medicine, Nursing

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

Responsible for determining the validity and authorising settlement of group life insurance claims

• 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
• Liaise with solicitors and other third parties during investigation and negotiation to seek guidance on the course of action that serves the best interest of AIA

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
• 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

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.