Assistant Manager, Claims Support
Great Eastern Lihat semua pekerjaan
- Kuala Lumpur
- Tetap
- Sepenuh masa
- Assist Team Lead to provide technical guidance and mentor a cluster of Associates.
- Handle end to end claims registration and setting reserves in the core and workflow imaging systems with high accuracy and within required turnaround time (service standards).
- Conduct screening of claim documents and verify policy information, including customer’s details, policy number, coverage, policy status with full attention to detail and ensuring submissions are complete and valid.
- Handle payment requisitions, payment rejections and payment escalations for approvals.
- Request for claim documents for incomplete submissions and proactively invite for death claim submissions.
- Review, validate and approve claim registration decisions recommended by Associates within the authority limit empowered.
- Claims Documentation & Records Management
- Perform screening, sorting and recording of incoming documents from digital submission channel.
- Prepare and manage claim documents, including merging, splitting, and organizing submissions based on benefit type and provider category.
- Cross check information across different product systems to achieve seamless claim experience
- Customer & Business Partner Relations
- Liaise professionally with policyholders, claimants, agents, medical providers and internal stakeholders to follow up on outstanding requirements and ensure smooth claims processing.
- Provide excellent service and build strong working relationships with customers and distribution channels through responsive and empathetic support to achieve smooth claims processing operations.
- Handle and provide guidance to Associates on sensitive customer escalations to achieve fair and timely resolution.
- Compliance, Process Improvement & Team Support
- Adhere to internal policies and external regulatory requirements to maintain integrity and trust in our claims operations.
- Support continuous improvement initiatives and manage execution of process and system enhancements performed by staff while maintaining service excellence.
- Take on ad hoc administrative or operational tasks as assigned by the supervisor.
- Diploma or degree holder in business or healthcare administration, preferably with 3 to 5 years of experience in claims administration, operations support, or customer service
- Strong knowledge in insurance claims or policy administration workflows.
- Strong communication, stakeholder management and decision making skills.
- High resilience in a fast paced environment.
- Customer-centric and meticulous with the ability to work under pressure.
- Possess good communication skills and a proactive approach to problem-solving.
- Are eager to learn and grow in a fast-paced, collaborative environment that values innovation and service excellence.