Assistant Manager/Manager, Medical Claims

Location: Central Region
Job Type: Permanent
Reference: JO-1909-6318

Job Purpose

You will be handling insurance claims assessment under the accident and health plans. You will also be given the opportunity to be part of an exciting team with involvement in service excellence initiatives and projects to improve the claims experience.

The Job

  • Provide accurate and timely assessment of filed medical claims within the required service standards and ensure that claims are paid accurately and promptly;
  • Handle early claim investigation, complex claims and appeals;
  • Build collaborative relationships with and ensure that claims are well managed for both internal and external key stakeholders (i.e policyholders, beneficiaries, distribution servicing rep, medical institutions) to achieve claims business objectives;
  • Deliver excellent service and enhance customer and distribution channels relationship management;
  • Attend to claims enquiries;
  • Review claims processes and participates in process improvement projects/ initiatives/ system enhancement for the department, including establishing claims best practices;
  • Ensure compliance with internal and external regulatory and legal matter; and
  • Guide and train junior staff

Job requirement:

  • 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; and
  • A team player.