Assistant Manager, Group B40 Claims (GETB)

 Responsible to lead the Critical Illness claims section.  This role to ensure SLA of claims processing is met and properly done according to the SOP & guidelines.  You are also responsible to assist supervisor for claims management including TPA monitoring.

• Monitor and ensuring claims are assessed and processed fairly and promptly by claims team and TPA, both meet SLA (including TAT, productivity, Quality, Ageing and etc.)
• Ensure all claims processes are comply accordingly to policy annexure, regulation and SOP guideline (including Bank Negara Malaysia, Malaysian Takaful Association, Ombudsman for Financial Services and etc.)
• Support and respond to internal and external stakeholders on timely manner (Including internal teams, hospitals, members, third party administrator, auditors and ect.)
• Carry out all management support tasks assigned set by timely and accurately within deadline department's stakeholder and management
• Prepare reports assigned including management reports, periodic reports team performance & productivity reports
• Guide subordinate towards personal development
• Enhance competency of subordinate in meeting SLA requirement
• Prepare and update claims guidelines
• Act as liaison person to deal with TPA team for continue improvement purposes
• Conduct claim investigation for suspicious cases if required
• Participate in product briefing or discussion
• Participate in projects, initiatives, assignments, and ad-hoc tasks assigned by superior.

•  Tertiary qualification preferably in science, biomedical science, medical with insurance or takaful qualification as added advantage
• Experience of at least 3 years in Medical, Takaful or Life Insurance company’s Claims Department
• Possess leadership, results driven and positive working attitude.
• Is analytical to see overall picture and able to work independently
• Have sense of urgency and business acumen
• Is a team player
• Possess good communication skills, verbal & non-verbal.