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Insurance Claim Specialist

4 months ago

Kuala Lumpur, Malaysia EPS Ventures Sdn Bhd Full time

**Position : Insurance Claim Specialist**

**Tenure : 1 year contract ( Immediate Hiring)**

**Working Hour : Standard**

**Working location : Jalan Duta**

**Salary : RM 6500 - RM 7000**

**Responsibilities**:

- Receive, validate, and manage new claims.
- Review and approve claims within authority limits, preparing files for presentation to capacity partners for significant losses.
- Respond to client inquiries and conduct diary follow-ups.
- Validate claims for third-party schemes and establish proof of loss by analyzing medical documentation and conducting investigations.
- Document all actions related to medical claims and resolve them by approving or denying documentation, calculating benefits, and initiating payments or composing denial letters.
- Maintain quality customer service by adhering to company practices and promptly addressing customer inquiries.
- Prepare monthly reports summarizing claim information.
- Stay updated with industry knowledge through educational opportunities and professional organizations.
- Ensure compliance with company policies, procedures, and regulatory requirements, including FCA regulations.

**Job Requirement**
- Bachelor’s Degree and 5 or more years of experience in the Claims
- High level of communications and interpersonal skills with practical Insurance knowledge. Good teamwork, ability to keep pace with new developments and proactive self-starter

**Job Type**: Contract
Contract length: 12 months

Pay: RM6,500.00 - RM7,000.00 per month

Schedule:

- Monday to Friday