A&H Claims Specialist (Executive / Senior Executive)

Accident & Health Claims Specialist (Executive / Senior Executive)

Hyppies Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia

Join one of the most prominent insurance companies as an Accident & Health Claims Specialist (Executive / Senior Executive) ! This role involves accurate and fair processing of A&H claims within agreed timelines and ensuring compliance with policies, guidelines, and regulatory standards.

Key Responsibilities

• Assess and process Accident & Health (A&H) claims accurately and fairly within agreed timelines.
• Ensure all claims decisions comply with policy terms, internal guidelines, regulatory standards, and reinsurance arrangements.
• Conduct necessary investigations and liaise with claimants, medical providers, financial consultants, and other stakeholders to validate claims.
• Monitor and follow up on outstanding documents or information to support timely adjudication.
• Collaborate with internal teams to ensure smooth end-to-end claims handling and adherence to service level agreements.
• Handle customer enquiries and appeals with professionalism and empathy, ensuring a positive experience.
• Contribute to process and system improvement initiatives, including testing and feedback for system enhancements.

Qualifications & Experience

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