About the Role
- Serves as the subject matter expert (SME) for claims technical matters across Life and Health insurance products across the Group and AIA entities and works closely with the business and claims operations team.
- Lead the development and continuous improvement of the Group Claims guidelines and framework.
- Establish Claims Technical Excellence across the Group to increase competitive advantage by strengthen claim control and risk management
- Responsible for the execution & governance of group’s integrated health strategy for healthcare claims administration
Responsibilities include, but are not limited to, the following :
Claims Governance, Control and Risk ManagementManage and maintain Group-wide Operations Standards, procedures and guidance notes to ensure consistent governance and effective risk mitigation
Collaborate with key stakeholders to complete the risk and compliance reporting requirements for various forumsDrive the achievement of Group business goals in Claim control and risk managementSupport the review and assessment of high-value claims to ensure accuracy and integrity.Collaborate with key stakeholders to deliver new innovative Claims capabilities to support the delivery of Group business goals (Gen AI, AI based FWA and auto adjudication, OCR and claims processing)Champion data-driven decision-making by defining claims analytics and KPI’s that reflect quality, turnaround and leakage metrics.Lead the development and continuous improvement of the Group Claimsguidelines and framework.Support the development of claims operation model for growing marketsPerform operational due diligence to support potential M&AJob Requirements :
Minimum 10-15 years of experience in Claims Operations, preferably in a regional or group-level role.Proven experience in claims governance, risk management and fraud detectionStrong organisational and management skills to lead multi-functional teamsStrong influencing skills to engage partners and stakeholders in the delivery of key goalsEffective communication and relationship skills to engage senior level stakeholdersAbility to demonstrate independent leadership, judgment, and decision makingAbility to adjust to multiple and changing priorities, remaining flexible, open, and collaborativeExperience in driving end to end Claims automation and STP for Life and Health ClaimsExposure to digital transformation initiatives in claim (e.g. AI, OCR, auto adjudication)Build a career with us as we help our customers and the community live Healthier, Longer, Better Lives.
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