About the Job
Assess and negotiate claims within company limits, while providing guidance and technical support to Business Units/Branches on the claims process.
Responsibilities
Assess, investigate and negotiate settlement of claims within personal authorization limit set by the Company.
Provide a prompt and efficient claims service to claimants and intermediaries.
Assess the performance of our Service Providers to align with Company's service standards.
Ensure accurate recording and retention of claims documents and correspondence.
Ensure claims reserves are maintained appropriately and adequately provided at all times.
Pursue claims Subrogation and Co/RI recoveries.
Advise Business Units / Branches of the medical claims process and provide claims technical support when necessary.
Process, verify and settle medical claims as per policy terms and conditions within the benchmarks.
Process, verify and settle Foreign Workers claims as per policy terms and conditions within the benchmarks
Responsible to ensure that all legitimate claims are settled promptly and fairly and within company's cost effectiveness.
Ensure compliance of Customer Service Standards adopted by the Company.
Ensure compliance of the Quality Objectives adopted by the Claims Department.
Ensure compliance with BNM guidelines and Company's claim's policy.
Report adverse trends identified to Business Managers / Functional Manager.
Ensure fraudulent claims are investigated thoroughly and relevant action taken.
Ensure claims leakages are minimized.
Ensure claims reviews are conducted as scheduled.
Regular liaison with underwriters and business units in relation to issued affecting policy and claims when arises.
To be successful in this role, you will need to have
Bachelor's degree or equivalent experience
Fresh graduates are welcome to apply
Good communication skills, written and spoken
Good teamwork and interpersonal skills
Strong analytical skills and proficient in negotiation
Detail-oriented
Customer focused and results-driven
Problem-solving skills
Good planning and organization skills
Strong time management
Proactive in responsibilities
Benefits
Hybrid Workplace (depends to nature of role), Training, Medical, Dental and Vision, Birthday Leave, Insurance Coverage, Car and Housing Loan Interest Subsidy, Long Service Award, Company Annual Dinner, Sports Club.#J-18808-Ljbffr