Specialist / Lead Specialist - Major Claims

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About the Role

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

About the Role

• Provides high-quality claims services in authorized claims transactions forMajor 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 Authorityand 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