a) Manage and optimize end-to-end user claims process, including evaluation, rejection, and appeal of claim cases within agreed timelines.
b) Careful usage of the claim payout expenditure, ensuring that it is kept within the approved annual budget, optimizing financial resources while maintaining high levels of customer satisfaction.
c) Manage high-priority and critical claims, ensuring swift and satisfactory resolutions while maintaining professional communication with customers.
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Review claims documentation, policy coverage, medical evidence, and loss details to determine claim validity, liability, and entitlement in accordance with Company guidelines and delegated authority.
Assess, review, investigate, approve and process Major Claims (Death and Critical Illness) accurately and timely, applying sound technical judgment and appropriate risk controls.
Utilize digital claims systems, workflow tools, and data dashboards to manage claim assessments, monitor turnaround time and ensure adherence to service level and quality benchmarks.
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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 and environments we live in. Encompassing our ambition of helping a billion people live Healthier, Longer, Better Lives by 2030.
And to get there, we need ambitious people who believe in playing an important part in shaping that future. People seeking unmatched career and personal growth opportunities, who are driven to work with, and learn from some of the most inspiring and supportive leaders in the business.
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Review claims documentation, policy coverage, medical evidence, and loss details to determine claim validity, liability, and entitlement in accordance with Company guidelines and delegated authority.
Assess, review, investigate, approve and process Major Claims (Death and Critical Illness) accurately and timely, applying sound technical judgment and appropriate risk controls.
Utilize digital claims systems, workflow tools, and data dashboards to manage claim assessments, monitor turnaround time and ensure adherence to service level and quality benchmarks.
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Independently assess complex claims by applying strong technical judgment, policy interpretation, and medical understanding to ensure fair and accurate claim outcomes.
Leverage digital tools, rules engines, and available automation outputs to enhance assessment efficiency, while exercising human judgment for cases requiring interpretation, exceptions, or escalation.
Analyze medical reports, invoices, and supporting documentation to validate claim eligibility, identify inconsistencies, and determine appropriate claim decisions in line with policy terms and exclusions.
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Provides HR administrative support across compensation & benefits, personnel data management, HR administration, onboarding/offboarding, HR reporting and HR projects, including payroll assistance, record keeping, HRIS updates, training coordination, and compliance support.