Claims Examiner Executive, Non-motor

2 weeks ago

Kuala Lumpur, Malaysia Allianz Full time

Looking for a career that allows you to take ownership of your work?
Engage proactively in projects to improve processing efficiency and enhance system functionalities. Additionally, process Non-motor claims, including Property, Marine Hull, Marine Cargo, Personal Accident (PA), Liability, and Health& Safety (H).
**You'll be responsible for**:

- Identifying and proposing enhancements for both processing and system functionalities of Non-motor Claims in the endeavor of ensuring an effective claims processing
- Collaborate with IT, vendors, and end-users from various departments to define requirements, testing scopes, and execute user acceptance tests for system enhancements.
- Evaluating, processing, and managing insurance claims to ensure accuracy, adherence to policy terms, and timely resolution. Key responsibilities include:

- Claim Review: Analyzing claims to determine coverage eligibility, policy terms, and applicable deductibles.
- Documentation: Gathering and reviewing claim documentation, such as incident reports, medical records, photographs, and other evidence.
- Coverage Determination: Assessing policy coverage to determine whether the claim falls within the scope of the policy and its limitations.
- Adjudication: Making final decisions on claim settlements and payments based on policy terms, investigation results, and legal considerations.
- Negotiation: Engaging in negotiations with claimants, policyholders, and other relevant parties to settle claims and address any disputes.
- Communication: Effectively communicating with claimants, policyholders, agents, and legal representatives to provide updates on claim status, request additional information, and address inquiries.
- Fraud Detection: Identifying and flagging potentially fraudulent claims and working with investigative teams to mitigate fraud risk.
- Customer Service: Providing high-quality customer service by addressing claimants' concerns, answering questions, and guiding them through the claims process.
- Monitor outstanding claims files, ensure proper claims management by service providers i.e. Adjuster, Surveyors, Lawyers etc.
- Attend to claims related queries and discussions with customers, agents, brokers, sales and any other stakeholders.
- Offer insights from claims perspective to support business acquisition and product development efforts and conduct necessary claims training for relevant stakeholders whenever required.

**Important to your success**:

- Bachelors’ Degree or equivalent, in any related field.
- Fresh graduates are welcome to apply.
- Possessing working experience in system enhancement projects in financial institutions will be advantageous.
- Possessing working experience in claim processing will be advantageous.
- Able to work independently and as a team player.
- Good communication skills.
- Ability to leverage AI tools like ChatGPT for data analysis and generating actionable insights.

68935 | Customer Services& Claims | Professional | Non-Executive | Allianz Malaysia | Full-Time | Temporary

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