Life Claims Executive

1 day ago


Petaling Jaya, Selangor, Malaysia MCIS LIFE Full time 60,000 - 90,000 per year

ROLE SUMMARY

Overseeing the Medical Claims unit and ensuring that all the administrative functions in this section are properly processed and promptly settled in accordance with established corporate policies, rules, regulations and guidelines. Including processing and approval of medical claim. Additional responsibilities include new product and project launch including requirement and testing.

MAIN RESPONSIBILITIES

1. Verify and approve cases within specific guidelines and Authority limit.

2. Conduct review on outstanding claims, follow up and send reminders for pending cases.

3. Monitor and ensure that productivity and Service Level Agreement are met within team.

4. Handle claims enquiries.

5. Handle complaint case, correspondence from FMOS and BNM within Service Level Agreement

6. Conduct training to new joiners.

7. Highlight trends and breakdown in services.

8. To review process and documentation on claim processes, operation manual, system manual and guidelines.

9. To review process and documentation to ensure business processes are in line with system and implement new processes.

10. To perform system testing, data cleansing and new product testing.

11. Carry out ad hoc projects/report assigned by superior.

12. Carry out assigned KPI.


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