Job Summary1. Responsible for managing & supervising Health team to ensure all claims handling/settlement activities are within stipulated TAT and following regulatory guidelines.
2.
To provide preferred claims experience in accordance to the service standard and procedure guideline set
3.
To coach and provide regular training to the team.
4
Fraud, Waste & Abuse Management
5.
Vendor Management
Job Responsibilities:
1.
Claims Operations
· Manage and supervising the team to ensure claims are settled / concluded promptly.
· Handle task assigned independently or with little supervision and to ensure Company's interests are fully protected by minimizing the claims costs and maximizing recoveries.
· Verify policy liability and alert underwriters on any suspicious, fraudulent claims
2.
Claims Costs
· Claims Investigations – ensure that all claims are properly investigated and settled on a timely basis in accordance with the agreed policies, processes and operational procedures.
· Claims Costs – managing claims settlement costs and related claims expenses, and ensure compliance with internal controls
3.
Claims Reserving
· Reserves – ensures accuracy of reserve type used and adequacy of reserves for claims handled so that the Company’s liabilities are properly reported, and in compliance with Group reserving policies.
· Reviews – ensure that claims assigned are reviewed regularly until closure
4.
Service Delivery
· Claims Service –provide good claims service.
· Ensure team is achieving the TAT -registration of claims within 2 days from notification
Approval of claims within 5 days from last document date
· Meet the claims minimum standards as defined in the Bank Negara guidelines.
5.
Customer Service
Response to Customers –ensure team provide prompt response to internal and external customers at all times.
6.
Projects & Reporting
· Participate in Claims Ad hoc projects.
· Contribute to the preparation of statistical reports on claims information required internally or externally.
Job Requirements:MINIMUM QUALIFICATIONS
Education
Degree in any and/or related
PROFESSIONAL
(i.e. insurance / accounting, etc.)
AMII /ACII / DMII or equivalent insurance qualifications
MINIMUM YEARS OF EXPERIENCE
Minimum of 5-10 years’ experience in and /or similar role / capacity
SKILLS
(i.e. language, IT software, etc.)
· Proficient in English
· Possess good presentation skills
· Possess good negotiation skills
· IT literate
PERSONAL QUALITIES
· Mature personality
· Able to work independently and as Teamwork
· Self - motivated
· Team player
OTHER REQUIREMENTS
Able to handle high volume of work with speed and accuracy
Would you like to wake up every day driven and inspired by our noble mission and to work together as one global team to empower people to live a better life? Here at AXA we strive to lead the transformation of our industry. We are looking for talented individuals who come from varied backgrounds, think differently and want to be part of this exciting transformation by challenging the status quo so we can push AXA - a leading global brand and one of the most innovative companies in our industry - onto even greater things.
In a fast-evolving world and with a presence in 64 countries, our 166,000 employees and exclusive distributors anticipate change to offer services and solutions tailored to the current and future needs of our 103 million customers.
https://www.axa.com.my/
AXA Affin General Insurance Berhad is a joint venture between AXA Group and Affin Holdings Berhad. We are one of the fastest growing general insurance companies in Malaysia, and the No.1 leader in Medical and Health insurance (source: ISM). We provide comprehensive and tailored protection solutions to individuals and businesses in the areas of Motor, Home, Accidental, Travel and Commercial insurance.
We pride ourselves in conducting business responsibly, and building long-term relationship of trust when serving almost a million Malaysian customers, with over 800 employees in 22 offices, as well as over 4,000 agents nationwide, as well as our brokers and key bank partners.
We are the best organization that demonstrate drive, commitment and tenacity to champion diversity and inclusion with workplace practices that enable our current & future employees to achieve work-life integration.
So, what are you waiting for? Come and JOIN us!
https://youtu.be/V7mXMUtq9Bc