Determining policy coverage, establishing proof of loss and ensuring proper documentation of claims travel, health and accident plans within the required service standards and ensure that claims are paid accurately and promptly;
Handle claim investigation and appeals;
Review and improve claims processes including establish claims best practices;
Deliver excellent service to our policyholders;
Look out for fraudulent cases/Frequent Claims Experience of claimant;
Ensuring reserve adequacy and reporting large losses to management in a timely manner;
Ensuring legal and audit compliance in all claims activities;
Managing internal/external customers' enquiries;
Handling disputes of claim settlements/Claims Appeal – will escalate to Team Lead;
Quarterly file reviews to ensure reserve adequacy of active claims and closure of inactive claims;
Take accountability in considering business and regulatory compliance risks and takes appropriate steps to mitigate the risks;
Maintain awareness of industry trends on regulatory compliance, emerging threats and appropriate steps to mitigate the risks; and
Highlight any potential concerns/risks and proactively shares best risk management practices.
Diploma or Degree or Professional Insurance Certificate with at least 3 year of relevant accident and health claims experience;
Prior experience in life claims and personal accident claims will be an added advantage;
Strong analytical, written and communication skills;
Customer-centric and meticulous with the ability to work under pressure;
A team player;
High level of integrity, takes accountability of work and good attitude over teamwork; and
Takes initiative to improve current state of things and adaptable to embrace new changes.
To all recruitment agencies: Great Eastern does not accept unsolicited agency resumes. Please do not forward resumes to our email or our employees. We will not be responsible for any fees related to unsolicited resumes.