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Claims Executive

Claims Executive

Takaful IKHLASKuala Lumpur, Kuala Lumpur, Malaysia
4 hari lalu
Penerangan pekerjaan

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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    Buat amaran kerja untuk carian ini

    Executive • Kuala Lumpur, Kuala Lumpur, Malaysia