Executive, Claims (Group Business)

1-3 Years

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Early Applicant

Job Description

Job Description

Job Description:

Assess employee benefits claims within authority limit according to policy terms and conditions
Review and audit claims processed by third-party administrator (TPA) to ensure adherence to policy wordings and guidelines
Review TPA performance against service level agreement
Communicate with policyholders, brokers, and other stakeholders to resolve claims efficiently
Handle appeals and complaints. Identify and escalate complex claims to team lead or manager
Ensure that the job's KPIs are met, compliance with company policies and regulatory requirements
Manage and respond to emails and customer calls in a timely and professional manner
Undertake any other duties or projects as assigned by the team lead or manager

Qualifications:

Diploma or Degree in any discipline
Ideally 1 to 2 years of working experience in Employee Benefits or Accident & Health claims handling
Health Insurance and Certification in General Insurance (BCP, PGI & ComGI). Candidates without may be considered if willing to pursue the exams.
Excellent communication and interpersonal skills
Good customer service and complaint handling skills
Attention to details; strong analytical, organisational and time management skills