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Senior Investigation Lead
3 weeks ago
At Great Eastern Life Malaysia, we are committed to providing the best possible solutions for our customers. As a leader in the insurance industry, we strive to maintain the trust of our policyholders by ensuring that all claims are investigated fairly and thoroughly.
The AVP, Investigation Unit plays a crucial role in this process, leading and managing the Investigation team to ensure that cases of suspicion of non-disclosure or pre-existing conditions are investigated promptly and according to agreed timelines.
To be successful in this role, you will need to establish and perform ongoing reviews on investigation guidelines, standard operating procedures, and processes to ensure consistency in practice and process efficiency.
You will also be responsible for establishing rapport with hospitals' medical record teams to ensure medical reports are furnished to the Company on a timely basis.
Additionally, you will ensure delivery of investigation cases outsourced by GETB following agreed SLA, review and finalize investigated cases within set TAT from complete documentation, and monitor and review Investigative Pending cases to ensure that the process is on track.
This role requires a high level of integrity, good management, organizational, and leadership skills, as well as the ability to work under pressure and produce high-quality work.
We are looking for a candidate with a Bachelor Degree in any field, preferably healthcare-related discipline, and minimum 15 years working experience as a claims assessor or equivalent, including at least 5 years working experience in a supervisory capacity.