Position Objectives:
- To ensure that the administration of Major Claims constantly meet the department goals that aligns and contributes to the Corporate Strategy.
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 stakeholderswithin 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.
