Claim Executive

JOB PURPOSE :

• Carefully checking Claim Process
• Completing specific tasks in Claims Dept as assigned by Head of HC Claim

PRINCIPAL ACCOUNTABILITIES :

• Assess and suggest/ make decision health care claim cases,
• Prepare letters requesting additional information/document
• Prepare inform letters accepting/declining claims
• Brief and suggest solutions as receiving complaint
• Coach newbies as requested
• Doing others as required which will change the % of time for other accountabilities

JOB SPECIFICATION :

• University graduated.
• Knowledge of law, medical, insurance.
• Having experience in life/health insurance.
• Good English communication

WORKING RELATIONSHIPS :

• Maintain good relationship with direct Manager, the sales force and other staff.
• Communicate clearly, politely, professionally with relevant bodies.
• Maintain good helpful relationship with claimants and diplomatically deal with difficult claims ensuring the maintenance of the company’s reputation

CHALLENGES :

• Ensure that all claims are handled promptly, effectively with agreed service standards.
• Ensure that clear and timely communications are made to sales force in relation to claims handling and payments.
• Make sure the work done is customer - focused
• Work under high pressure