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.