Job Summary

• Management and administration.
• Market intelligence.
• Claims Specialist.
• Performance Management.
• Fraud management.

Key Responsibilities

• Regular review of open files in order to identify root causes of claims leakage and the translation of those findings into action plans to reduce leakage through process improvements and/or training.
• To manage the specialised claims from point of notification up to settlement i.e.manage the progress of Adjusters investigation
• Periodic monitoring outstanding claim files with Adjusters.
• Review work processes and provide solutions in improvement of claim guidelines and work processes.
• To assist in department’s administrative works, systems and procedures for smooth operations and continuous improvement.
• Performs investigation of potential fraud cases to uncover the fraud pattern and also the parties involved.
• Developing claim reviews plans (including outstanding and closed cases).
• Review, investigate and actively involved in all complex and contentious claims referred to the team to ensure compliance with policy requirements and smooth settlement.
• Analyses and maintains an up-to-date knowledge and data of fraud trends in the market.
• Backup team members and assume the responsibilities as and when required.
• Perform other duties as delegates by the Management.
• Ensure compliance to policies, guidelines and regulations

Key Requirements

• Bachelors’ Degree or equivalent, in any related field / Associated MII / CII.
• Minimum 5 years’ experience in P&C claim handling.
• Well verse with claims processes and handling.
• Good policy understanding in terms of the policy conditions, exclusions etc.
• Good judgement and able to make decision.
• Good communication skills
• Familiar with the use of AI tools such as ChatGPT for tasks simplification