AVP, Investigation Unit

2 weeks ago

Kuala Lumpur, Kuala Lumpur, Malaysia Great Eastern Life Full time

Job Description - AVP, Investigation Unit (22000199)

Job Number:

22000199

Discover the GREAT in your career.

As a LIFE company, our customers are at the heart of all that we do. Being one of Asia's leading insurers for over a century, we have built a long-lasting legacy of trust with our customers over many generations. At the foundation of this trust is Integrity, Initiative, and Involvement – from the way we treat every customer relationship with honesty and transparency, to our proactive approach of delivering the best possible solutions in both life and general insurance.

Integrity, Initiative, and Involvement is what guides us. It is what makes us do the right thing, take the lead, and choose 'we' over 'me'. Our mission is to make life great for our customers because we understand what matters most to them, and we know how to help them protect it.

As a purpose-driven organisation committed to providing the best service and support to our policyholders, we are seeking an experienced professional to join our team as a AVP, Investigation Unit.

The Role:

  1. Lead and manage the Investigation team to ensure cases of suspicion of non-disclosure or pre-existing conditions are investigated fairly, thoroughly, and promptly following agreed timelines.
  2. Establish and perform ongoing reviews on investigation guidelines, standard operating procedures, and processes to ensure consistency in practice and process efficiency.
  3. Establish rapport with hospitals' medical record teams to ensure medical reports are furnished to the Company on a timely basis.
  4. Ensure delivery of investigation cases outsourced by GETB following agreed SLA.
  5. Review, establish, maintain, and update investigative processes in SOP.
  6. Ensure investigated cases are reviewed/finalized with decisions within set TAT from complete documentation.
  7. Monitor and review Investigative Pending cases to ensure that the process is on track and that these cases are finalized within the set TAT.
  8. Review investigation processes for continuous improvement.
  9. Attend to any other tasks assigned from time to time.
  10. Take accountability in considering business and regulatory compliance risks and take appropriate steps to mitigate the risks.
  11. Maintain awareness of industry trends on regulatory compliance, emerging threats, and technologies to understand the risk and better safeguard the company.
  12. Highlight any potential concerns/risks and proactively share best risk management practices.

Great Eastern Malaysia is committed to Equal Employment Opportunity, and all qualified applicants shall receive fair and equal consideration for employment.

Entity : Great Eastern Life Malaysia

Employment Type : Permanent

To all recruitment agencies: Great Eastern does not accept unsolicited agency resumes. Please do not forward resumes to our email or our employees. We will not be responsible for any fees related to unsolicited resumes.

About Great Eastern

Established in 1908, Great Eastern places customers at the heart of everything we do. Our legacy extends beyond our products and services to our culture, which is defined by our core values and how we work. As champions of Integrity, Initiative, and Involvement, our core values act as a compass, guiding and inspiring us to embrace the behaviours associated with each value, upholding our promise to our customers - to continue doing our best for them in a sustainable manner.

We work collaboratively with our stakeholders to look for candidates who exhibit or have the potential to embrace our core values and associated behaviours, as these are the key traits that we expect from our employees as they develop their careers with us.

We embrace inclusivity, giving all employees an equal opportunity to shine and play their role in exploring possibilities to deliver innovative insurance solutions.

Since 2018, Great Eastern has been a signatory to the United Nations (UN) Principles of Sustainable Insurance. Our sustainability approach around environmental, social, and governance (ESG) considerations play a key role in every business decision we make. We are committed to being a sustainability-driven company to achieve a low-carbon economy by managing the environmental footprint of our operations and incorporating ESG considerations in our investment portfolios; improving people's lives by actively helping customers live healthier, better, and longer; and driving responsible business practices through material ESG risk management.

The Person:

  1. Possesses a Bachelor Degree in any field, preferably healthcare-related discipline.
  2. Minimum 15 years working experience as a claims assessor or equivalent and at least 5 years working experience in a supervisory capacity.
  3. Good management, organizational, and leadership skills.
  4. Have the right attitude for hard work and able to produce high-quality work under pressure.
  5. High level of integrity, takes accountability for work, and has a good attitude towards teamwork.
  6. Takes initiative to improve the current state of things and is adaptable to embrace new changes.
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