Responsibilities
- Handle, process
and recommend settlement of claims diligently in accordance with policy
contract, company policy and procedures.
- Approving claims
for the peers with lower authority within the department benchmark/turnaround
time.
- To assist Unit
Head to monitor general enquiries and ensure complaints are attended within the
benchmark set by the department.
- To ensure
outstanding claim files are reviewed yearly and ensure claim reserves are
adequate with status updated.
- To assist Unit
Head with report generation from Merimen system e.g. OD daily productivity,
etc.
- To authorize
payments.
- To handle
incoming enquiries from internal or external parties via emails, phone calls
and letters.
- To authorize,
deny and determine extent of insurer’s liability on case of discharge that
surpasses the authority of an Executive.
- To ensure claims
recommendations and decisions are complied with legal requirements, industry
regulations, company policies and professional codes.
- Keep ratio of
outstanding claims at healthy level.
- Highlight to
supervisors and/or HODs of any deficiency in policy coverage and adverse claims
trends to facilitate corrective and appropriate action.
- Identifying
potential fraud and make appropriate referrals.
- To assist Unit
Head with any projects entrusted to the Unit and to lead team members in
certain projects.
- To accept any
roles that the management may assigned from time to time.