Claims Specialist

Job Purpose

To carry out claim processing related functions in claims effectively and timely in tandem with the company and department's objective in providing excellent service to customers.

Job Responsibilities

• Involved in handling of claims, processing from notifications, assessment of claim within delegated authority and make settlement within the guidelines and claims philosophy of the Dept.
• Review adjusters report and provide recommendation to superior on claims settlement for cases exceeding authority limit.
• Attending to internal and external customer enquiry on any claim status.
• Resolve complaints received from Ikhlascare.
• Prepare papers for recommendation to superior.
• Prepare preliminary loss advice / revised loss advice / settlement loss advice in CAB system for claims which involved co-follower and reinsurer.
• Prepare preliminary loss advice / revised loss advice / settlement loss advice for excess of loss (XOL) cases when meet 75% of net limits.
• Review claims file on monthly basis.
• Approve claim payment within authority limit.
• Liaising with other department, claimant and other external parties for the purpose of obtaining information in relation to claims matter.
• Carries out any task, relevant to the position, an assign by management from time to time.

Qualification & Experience

• Degree of any discipline.

Professional

• ACII / AMII.

Experience

• Preferably a tertiary education with at least 5 years of experience in the insurance industry.
• A minimum of 5 years' experience in NON - MOTOR claims processing.

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