Specialist - Claims

5 months ago


Cyberjaya, Malaysia AIA Full time

At AIA we’ve started an exciting movement to create a healthier, more sustainable future for everyone.
- It’s about finding new ways to not only better people's lives, but to better the communities and environments we live in. Encompassing our ambition of helping a billion people live Healthier, Longer, Better Lives by 2030._
- And to get there, we need ambitious people who believe in playing an important part in shaping that future. People seeking unmatched career and personal growth opportunities, who are driven to work with, and learn from some of the most inspiring and supportive leaders in the business._

Sound like you? Then read on.

About the Role

1. Process authorized claims transactions within the required benchmarks

2. Review and approve cases that exceeds subordinates’ authority within required benchmarks

3. Building and Developing complete skill sets for Claims Assessors

4. Claims Reporting

5. Trends Analysis

6. Staff Engagement
- Process all Inpatient, Outpatient claims and pre-approval requests received as per stipulated requirements
- Ensure meeting individual quality, turn around time and productivity benchmark
- Review/approve cases that exceeds subordinates’ authority
- Perform outbound call to customers when required
- Training of new joiners on claims processing rules and products knowledge including Review and Feedback for On-The-Job training cases
- Providing training in System Navigation and Processing Steps, towards certification with Claims Approval Authority, as stipulated in the Claims Approval Authority guidelines.
- Conduct regular claims review in claims performance to ensure claims principles/authorities are adhered to. Review claims decision making process to identify areas of claims risk management concerns for further improvements.
- Organize and implement team engagement activities to foster closer team spirit and create work life balance environment.
- Performs other responsibilities and duties periodically assigned by immediate manager in order to meet business requirements
- Build a career with us as we help our customers and the community live Healthier, Longer, Better Lives._


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