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Job Description
:This role is responsible for life claims processing, including Death, CI, WP, medical and accident claims, ensure the claims are assessed accurately, ethically, and within the stipulated Turnaround Time (TAT). It involves handling large amount claim or complex cases, providing technical guidance to junior assessors, and acting as a key point of contact for stakeholders such as distribution channels, medical vendor and other internal departments.
Responsibilities
Case Management & Approval: Review and approve claims within assigned authority limits; prepare thorough recommendations for cases exceeding that limit for Head of Claims/Committee approval.
Operational Excellence: Monitor team queues to ensure KPIs and Service Level Agreements (SLAs) are met consistently.
Quality Assurance: Conduct regular audits of claims files to ensure adherence to internal guidelines, regulatory requirements, and anti-fraud prot...