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Job Description - Assistant Manager, Group B40 Claims (GETB) (240001TR)

240001TR

Responsible for leading the Critical Illness claims section. This role ensures that the SLA of claims processing is met and properly executed according to SOP & guidelines. You are also responsible for assisting the supervisor in claims management, including TPA monitoring.

1. Monitor and ensure claims are assessed and processed fairly and promptly by the claims team and TPA, both meeting SLA (including TAT, productivity, quality, aging, etc.)
2. Ensure all claims processes comply with policy annexure, regulations, and SOP guidelines (including Bank Negara Malaysia, Malaysian Takaful Association, Ombudsman for Financial Services, etc.)
3. Support and respond to internal and external stakeholders in a timely manner (including internal teams, hospitals, members, third-party administrators, auditors, etc.)
4. Carry out all management support tasks assigned, completed accurately and within deadlines set by stakeholders and management
5. Prepare reports as assigned, including management reports, periodic team performance, and productivity reports
6. Guide subordinates towards personal development
7. Enhance the competency of subordinates in meeting SLA requirements
8. Prepare and update claims guidelines
9. Act as liaison with TPA team for continuous improvement
10. Participate in product briefings or discussions
11. Participate in projects, initiatives, assignments, and ad-hoc tasks assigned by superiors

1. Tertiary qualification preferably in science, biomedical science, or medical field, with insurance or takaful qualification as an added advantage
2. At least 3 years of experience in Medical, Takaful, or Life Insurance claims department
3. Possess leadership qualities, results-driven, and a positive working attitude
4. Analytical with the ability to see the overall picture and work independently
5. Sense of urgency and business acumen
6. Team player
7. Good communication skills, both verbal and non-verbal