Medical Claims Assessor - Fair, Fast & Compassionate

AIA NZ; Auckland; On-site; NZD 65,000 - 90,000; Full time

Job summary

AIA NZ is seeking a Claims Assessor - Medical to help customers during critical moments with careful, accurate claim evaluations. You will work with customers, medical professionals, advisers, and internal specialists to deliver fair outcomes and protect the integrity of the claims process.

You will join a team focused on accurate decisions, clear communication, and ongoing process improvements, contributing to AIA's Healthier, Longer, Better Lives mission.

Qualifications

• Experience in claims, administration, customer service, insurance, healthcare, or related environment.
• Strong communication and relationship-building skills for clear, empathetic explanations.
• Ability to analyze information and make balanced decisions with evolving data.
• High attention to detail and adherence to processes to ensure quality outcomes.
• Comfort with digital systems to manage workflows and documentation.
• Knowledge of medical terminology, claims practices, or risk/fraud processes is a plus.

Responsibilities

• Assess medical claims efficiently and accurately in line with policy terms and fair outcomes.
• Communicate decisions clearly and compassionately to customers and stakeholders.
• Build trusted relationships with internal teams, advisers, healthcare providers, and other stakeholders.
• Identify and manage risks, investigate potential non-disclosure or fraud and involve technical specialists as needed.
• Maintain accurate claim records, authorise payments, and complete administrative processes to a high standard.
• Contribute to continuous improvement initiatives to enhance customer experiences and claims processes.

Skills

Claims processing

Customer service

Communication

Attention to detail

Digital systems

Risk awareness

Job description

AIA NZ is seeking a Claims Assessor - Medical to help customers during critical moments with careful, accurate claim evaluations. You will work with customers, medical professionals, advisers, and internal specialists to deliver fair outcomes and protect the integrity of the claims process.

You will join a team focused on accurate decisions, clear communication, and ongoing process improvements, contributing to AIA's Healthier, Longer, Better Lives mission.