Executive, Claims-2
On-site · Kuala Lumpur, Kuala Lumpur, Malaysia
Job Summary
Provide dedicated claims services to claimants and Financial Service Consultants by ensuring delivery of key service objectives through efficient and effective claims management. Adjudicate Group Major Claims (Death, TPD, Critical Illness, Disability, Terminal Illness, etc.) and Group Medical Claims (Hospital & Surgical, Major Medical, Outpatient Specialist, Outpatient Clinical, Dental, etc.), ensure prudent and equitable claims decisions within service levels, comply with regulatory requirements, and work with underwriters and external parties to ensure accurate processing. Manage investigations with claims adjusters, legal advisors, medical institutions, claimants, and insurers; handle inquiries, service recovery, complaints, and appeals; follow up on outstanding requirements and provide status updates. Qualifications include 2-3 years in life/medical claims processing, a Diploma or Degree, and strong English communication; must be detail-oriented and customer-focused with strong collaboration and independence.
Required Qualifications
- 2 to 3 years of working experience in life and medical claims processing
- Diploma or Degree
- English proficiency (written and verbal)
- Detail-oriented with commitment to accuracy and quality
- Strong communication and relationship-management skills
- Ability to work under pressure and be self-motivated
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