Talent.com
Claims Technical Excellence

Claims Technical Excellence

AIA Hong KongKuala Lumpur, Kuala Lumpur, Malaysia
11 hours ago
Job description

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 Management
  • Manage 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 forums
  • Drive the achievement of Group business goals in Claim control and risk management
  • Support 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 markets
  • Perform operational due diligence to support potential M&A
  • Job 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 detection
  • Strong organisational and management skills to lead multi-functional teams
  • Strong influencing skills to engage partners and stakeholders in the delivery of key goals
  • Effective communication and relationship skills to engage senior level stakeholders
  • Ability to demonstrate independent leadership, judgment, and decision making
  • Ability to adjust to multiple and changing priorities, remaining flexible, open, and collaborative
  • Experience in driving end to end Claims automation and STP for Life and Health Claims
  • Exposure 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.

    You must provide all requested information, including Personal Data, to be considered for this career opportunity. Failure to provide such information may influence the processing and outcome of your application. You are responsible for ensuring that the information you submit is accurate and up-to-date.

    #J-18808-Ljbffr

    Create a job alert for this search

    Technical Excellence • Kuala Lumpur, Kuala Lumpur, Malaysia

    Related jobs
    • Promoted
    Lead Engineer

    Lead Engineer

    Soft Space Sdn BhdSeremban, Negeri Sembilan, Malaysia
    We are seeking a technically strong leader based in Malaysia to head our North America region projects.The Lead Engineer will take ownership of regional delivery, technical solutioning, and team le...Show moreLast updated: 20 days ago
    • Promoted
    Senior Business Analyst - Health Insurance (Fully Remote)

    Senior Business Analyst - Health Insurance (Fully Remote)

    CoverGo | InsurtechPort Klang, Port Klang, Malaysia
    Senior Business Analyst - Health Insurance (Fully Remote).Senior Business Analyst - Health Insurance (Fully Remote).Working on the latest tech for the Insurtech Market Leader.Working on the latest ...Show moreLast updated: 30+ days ago
    • Promoted
    Medical Claims Assessors, Officer / Senior Officer (VHIS, Remote / Hybrid)

    Medical Claims Assessors, Officer / Senior Officer (VHIS, Remote / Hybrid)

    Bowtie Life Insurance Company LimitedSelayang Municipal Council, Selayang Municipal Council, Malaysia
    Bowtie’s mission is to make insurance good again and our vision is to build a category-defining health insurance company. As a young and fast-growing company, grooming and learning from the next gen...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    Technical Solutions Architect II

    Technical Solutions Architect II

    Akamai Technologies GmbHSepang, Selangor, Malaysia
    Join the Technical Solutions Architect team.Akamai is working to simplify the way people work in the cloud.The team's mission is to accelerate innovation by making computing simple, scalable, acces...Show moreLast updated: 11 hours ago
    • Promoted
    Senior Sales Engineer

    Senior Sales Engineer

    SophosSeremban, Negeri Sembilan, Malaysia
    Sophos is a global leader and innovator of advanced security solutions designed to defeat cyberattacks.The company acquired Secureworks in February 2025, creating the largest pure‑play Managed Dete...Show moreLast updated: 9 days ago
    • Promoted
    • New!
    Manager, Strategy Management - Claims

    Manager, Strategy Management - Claims

    Prudential Hong Kong LimitedKuala Lumpur, Kuala Lumpur, Malaysia
    Manager, Strategy Management - Claims page is loaded## Manager, Strategy Management - Claimslocations : Kuala Lumpurtime type : Full timeposted on : Posted Todayjob requisition id : Prudential...Show moreLast updated: 11 hours ago
    • Promoted
    • New!
    Technical Warranty Engineer

    Technical Warranty Engineer

    Boon Siew Honda Sdn Bhd.Petaling Jaya, Selangor, Malaysia
    Technical Warranty Executive - After Sales.Add expected salary to your profile for insights.Monitor product quality issue occurrence and re-occurrence in the market using Dealer Warranty Claim data...Show moreLast updated: 9 hours ago
    • Promoted
    • New!
    Senior Associate - Claims (Regional Operations Support)

    Senior Associate - Claims (Regional Operations Support)

    AIA Hong KongCyberjaya, Selangor, Malaysia
    At AIA we’ve started an exciting movement to create a healthier, more sustainable future for everyone.It’s about finding new ways to not only better people's lives, but to better the communities an...Show moreLast updated: 11 hours ago
    • Promoted
    • New!
    Title : Associate Director, Claims

    Title : Associate Director, Claims

    Reinsurance Group Of America, IncorporatedKuala Lumpur, Kuala Lumpur, Malaysia
    RGA is a purpose-driven organization working to solve today’s challenges through innovation and collaboration.A Fortune 200 Company and listed among its World's Most Admired Companies, we’re the on...Show moreLast updated: 11 hours ago
    • Promoted
    • New!
    Protege RTW - Business Support Operations

    Protege RTW - Business Support Operations

    Airbus Customer Services Sdn BhdSepang, Malaysia
    Job Description : • • Opening Application for PROTEGE Program within Airbus in Malaysia.This program is for Malaysian fresh graduates only, as mandated by Malaysian Government.Kindly note this appli...Show moreLast updated: 18 hours ago
    • Promoted
    Technical Sales Specialist, Endoscope Repair

    Technical Sales Specialist, Endoscope Repair

    STERISShah Alam, Selangor, Malaysia
    Technical Sales Specialist, Endoscope Repair.Technical Sales Specialist, Endoscope Repair.Reporting to the Sales Manager of Endoscopy, you will identify new sales opportunities, manage key accounts...Show moreLast updated: 17 days ago
    • Promoted
    • New!
    Managing Consultant - Technical Risk & Safety

    Managing Consultant - Technical Risk & Safety

    Environmental Resources Management (ERM)Kuala Lumpur, Kuala Lumpur, Malaysia
    Managing Consultant - Technical Risk & Safety page is loaded • •Managing Consultant - Technical Risk & Safety • •locationsKuala Lumpur, Malaysia time typeFull time posted onPosted Today job r...Show moreLast updated: 11 hours ago
    • Promoted
    Manager, Customer Promise - Medical Reimbursement & Accident

    Manager, Customer Promise - Medical Reimbursement & Accident

    Prudential Assurance Malaysia BerhadKuala Lumpur, Kuala Lumpur, Malaysia
    The incumbent is responsible to manage an efficient and effective Claims team by meeting and exceeding management’s expectations on operational processes. The complexity of the insurance business re...Show moreLast updated: 18 days ago
    • Promoted
    • New!
    Senior Manager, Customer Promise - Healthcare Claims

    Senior Manager, Customer Promise - Healthcare Claims

    Prudential Hong Kong LimitedKuala Lumpur, Kuala Lumpur, Malaysia
    Senior Manager, Customer Promise - Healthcare Claims page is loaded • •Senior Manager, Customer Promise - Healthcare Claims • •locationsKuala Lumpur time typeFull time posted onPosted Today j...Show moreLast updated: 11 hours ago
    • Promoted
    • New!
    Process Executive - Claims Excellence (Cantonese Speaker)

    Process Executive - Claims Excellence (Cantonese Speaker)

    CognizantKuala Lumpur, Kuala Lumpur, Malaysia
    Job Responsibilities and Expectations : .Assist in validating and processing health insurance claims in accordance with Insurance Authority (IA) guidelines. Ensure accurate data entry and documentatio...Show moreLast updated: 9 hours ago
    • Promoted
    • New!
    Airbus - Protege RTW - Business Support Operations

    Airbus - Protege RTW - Business Support Operations

    Airbus Customer Services Sdn BhdSepang, Malaysia
    Job Description : • • Opening Application for PROTEGE Program within Airbus in Malaysia.This program is for Malaysian fresh graduates only, as mandated by Malaysian Government.Kindly note this appli...Show moreLast updated: 18 hours ago
    • Promoted
    • New!
    Associate Director, Organizational Change Management (OCM)

    Associate Director, Organizational Change Management (OCM)

    AvasantSelayang Municipal Council, Selayang Municipal Council, Malaysia
    Organizational Change Manager (OCM).Avasant is a Los Angeles, California based top management consulting and research firm providing Strategic Sourcing, IT and Business Transformation, and Global S...Show moreLast updated: 9 hours ago
    • Promoted
    • New!
    Process Executive - Claims Operations (Cantonese Speaker)

    Process Executive - Claims Operations (Cantonese Speaker)

    CognizantKuala Lumpur, Kuala Lumpur, Malaysia
    The Medical Claim Advisor is responsible for daily claim processing and evaluating medical insurance claims to ensure accuracy, compliance, and timely resolution. The role involves reviewing documen...Show moreLast updated: 9 hours ago