A&H Claims Specialist

2 days ago

Kuala Lumpur, Kuala Lumpur, Malaysia Hyppies Full time 60,000 - 120,000 per year

Here's your chance to join one of the most prominent Insurance companies as an
A&H Claims Specialist (Executive/Senior Executive)

Key Responsibilities

  • Assess and process Accident & Health (A&H) claims accurately and fairly within agreed timelines.
  • Ensure all claims decisions comply with policy terms, internal guidelines, regulatory standards, and reinsurance arrangements.
  • Conduct necessary investigations and liaise with claimants, medical providers, financial consultants, and other stakeholders to validate claims.
  • Monitor and follow up on outstanding documents or information to support timely adjudication.
  • Collaborate with internal teams to ensure smooth end-to-end claims handling and adherence to service level agreements.
  • Handle customer enquiries and appeals with professionalism and empathy, ensuring a positive experience.
  • Contribute to process and system improvement initiatives, including testing and feedback for system enhancements.

Qualifications & Experience

  • Minimum
    1-2 years of experience
    handling Life or Health insurance claims.
  • Good command of English, with proficiency in Mandarin (to manage invoices containing Chinese characters).
  • Strong analytical, communication, and problem-solving abilities.
  • Customer-focused mindset with resilience in handling pressure and complex cases.
  • Self-driven, organized, and capable of working independently with minimal supervision.
  • Cooperative team player with maturity and accountability.

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