Job Purpose
Responsible to lead the Critical Illness claims section.
This role to ensure SLA of claims processing is met and properly done according to the SOP & guidelines.
You are also responsible to assist supervisor for claims management including TPA monitoring.
The Job
Monitor and ensuring claims are assessed and processed fairly and promptly by claims team and TPA, both meet SLA (including TAT, productivity, Quality, Ageing and etc.)
Ensure all claims processes are comply accordingly to policy annexure, regulation and SOP guideline (including Bank Negara Malaysia, Malaysian Takaful Association, Ombudsman for Financial Services and etc.)
Support and respond to internal and external stakeholders on timely manner (Including internal teams, hospitals, members, third party administrator, auditors and ect.)
Carry out all management support tasks assigned set by timely and accurately within deadline department's stakeholder and management
Prepare reports assigned including management reports, periodic reports team performance & productivity reports
Guide subordinate towards personal development
Enhance competency of subordinate in meeting SLA requirement
Prepare and update claims guidelines
Act as liaison person to deal with TPA team for continue improvement purposes
Participate in product briefing or discussion
Participate in projects, initiatives, assignments, and ad-hoc tasks assigned by superior.
Our Requirements
Tertiary qualification preferably in science, biomedical science, medical with insurance or takaful qualification as added advantage
Experience of at least 3 years in Medical, Takaful or Life Insurance company's Claims Department
Possess leadership, results driven and positive working attitude.
Is analytical to see overall picture and able to work independently
Have sense of urgency and business acumen
Is a team player
Possess good communication skills, verbal & non-verbal.
Seniority levelNot Applicable
Employment typeFull-time
Job functionAnalyst and Other
IndustriesInsurance#J-18808-Ljbffr