Medical Claims, Senior Executive

Responsibilities

Job Function:

• To achieve the PMS objectives, ensure claims are settled within the TAT set and to handle enquiries from policy owner, Life Assured, broker, banker, agent and marketer.

Key Duties & Responsibilities

• Process and assess all minor claims within the TAT set and in accordance to the stipulated guidelines, rules and regulations.
• Review and follow up closely on all minor claims within the timeline set.
• Liaise with other department on non-disclosure or pre-existing condition claims, error in system, wrong data reflected in TPA system and other claims related matters.
• Ensure minimum daily productivity is met
• Ensure minimum PMS is met
• Attend to and handle enquiries from internal staffs, branch staffs, agents, brokers, marketers and policyholders / claimants.
• Support Section Head to continuously review processes, to identify and resolve any gaps through constructive feedback, and implement process improvement, where appropriate.
• Record, update, review and prepare statistics or information, as and when required by the Management.
• Handle department projects and other miscellaneous cases, as and when necessary.
• Conduct internal and external training in claims related matters, as and when required.
• Undertake any other work, duties and other Medical Claims Department matters, as and when necessary.

Requirements

• Candidate must possess at least a Bachelor's Degree from any field of studies
• At least 2-3 year(s) of working experience in the related field is required for this position.
• Preferably Executives with exsposure to minor claims (reimbursement)

• Posted: October 2, 2024
• Department: Medical Claims
• Company: Life Insurance
• Location: Menara Tokio Marine Life, 189 Jalan Tun Razak
  Note: Tokio Marine Life Insurance Malaysia Bhd. reserves the right to change the scope of responsibilities as deemed fit, as and when necessary. The staff will be informed/prepared beforehand shouldwhen such occasions arise.