Assistant Manager/Manager Claims Control & Specialised Claims Unit

Job Summary

• Management and administration.
• Market intelligence.
• Claims Specialist.
• Performance Management.
• Fraud management.

Key Responsibilitie

• sRegular review of open files in order to identify root causes of claims leakage and the translation of those findings into action plans to reduce leakage through process improvements and/or training
• .To manage the specialised claims from point of notification up to settlement i.e.manage the progress of Adjusters investigatio
• nPeriodic monitoring outstanding claim files with Adjusters
• .Review work processes and provide solutions in improvement of claim guidelines and work processes
• .To assist in department's administrative works, systems and procedures for smooth operations and continuous improvement
• .Performs investigation of potential fraud cases to uncover the fraud pattern and also the parties involved
• .Developing claim reviews plans (including outstanding and closed cases)
• .Review, investigate and actively involved in all complex and contentious claims referred to the team to ensure compliance with policy requirements and smooth settlement
• .Analyses and maintains an up-to-date knowledge and data of fraud trends in the market
• .Backup team members and assume the responsibilities as and when required
• .Perform other duties as delegates by the Management
• .Ensure compliance to policies, guidelines and regulation

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Key Requiremen

• tsBachelors Degree or equivalent, in any related field / Associated MII / CI
• I.Minimum 5 years experience in P&C claim handlin
• g.Well verse with claims processes and handlin
• g.Good policy understanding in terms of the policy conditions, exclusions et
• c.Good judgement and able to make decisio
• n.Good communication skil
• lsFamiliar with the use of AI tools such as ChatGPT for tasks simplificati