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Claims Executive

Takaful IKHLASKuala Lumpur, Kuala Lumpur, Malaysia

5 days ago

Job description

JOB PURPOSE

To implement and enforce the claims Standard Operating Procedures in respect of the claims processing efficiency for group business GTT
To supports client service objectives with an efficient and effective processing guided by Islamic principles, which includes the following - :
prompt settlement without compromising prudent decision making.
claims handling in a proper manner (efficient, fair and quick) within the specified time frame through quality management system (IT); and
Responds promptly and appropriately to client’s needs and request.
Carry out other tasks, relevant to the position as assigned by Assistant Vice President / Vice President from time to time

JOB RESPONSIBILITIES

Scanning and registration of claim upon notification

Processing major claim i.e Death and Critical Illness claim for GTT and Flexi-Idaman

Issuance of requirement letters for incomplete claim submission

Investigation of non-disclosure or pre-existing cases by sending out Medical Inquiry or Extended Questionnaire to hospitals / clinics.

Handling Misrepresentation cases which involved either policy termination or variation to the certificate (conditional acceptance)

Referral of cases to Re-Takaful for their approval for cases above claims authority limit

Preparing recommendation in admitting liability / repudiation of claims and get the approval based on the authority limit as per LOFA.

Monitoring the rejected transaction of e-payment, and re-issuance of Payment.

Rejection letter issuance which involves certificate termination

Liaising with marketing i.e Corporate Solutions and Banca team for any claims related issues

Provide response to customer enquiries and complains within specified TAT.

Approval of claim according to Financial Authority Limits granted

Performing system related UAT (user acceptance test) for the new enhancement of the system or new product

Handling rejected IRB e-invoicing / self-billing and resubmission to IRB

Adhoc request or task as and when required by supervisor

QUALIFICATION & EXPERIENCE

Minimum Degree holder, preferably in Family Takaful / Life Insurance related fields.

Knowledge in basic computers word, excel and Power Point.

Knowledge in OMNI and I-Family system is an added advantage.

PROFESSIONAL

Professional qualification of AMII, i.e. Associateship of The Malaysian Insurance Institute is an added advantage

EXPERIENCE

Experience in Family Takaful / Life Insurance Industry for more than 2 years

SENIORITY LEVEL

Executive

EMPLOYMENT TYPE

Full-time

JOB FUNCTION

Administrative, Health Care Provider, and Supply Chain

Insurance

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Executive • Kuala Lumpur, Kuala Lumpur, Malaysia

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