Claims Lead

The manager for Claims is tasked to ensure that claims adjudication for all claims cases are accurately and timely processed in accordance with the terms and conditions of the policy. He/She should be able to manage the claims team and ensure to have the capacity to process the incoming volume of claims cases. All established processes should be aligned with the compliance requirements and controls are properly in place.

Job Responsibilities:

• Lead the Claims Team covering both Group and Individual Insurance.
• Monitors all the submitted claims cases (death, medical, accident, critical illness, etc.) and ensures that each request is adjudicated within the service level agreement.
• Manage the claims team to ensure that all processes are in place and the team has the right capacity to render the required services.
• Prepares the required management reports and perform the necessary analysis for management discussions and decisions.
• Collaborates with other divisions for various initiatives and claims servicing requirements.
• Regular review and assessment of processes to ensure that process controls remain updated and for continuous improvement of services.
• Acts as the subject matter expert for Claims ensuring that the different projects and initiatives are aligned with the business rules of the process.
• Participate and keep the members of the team engaged in various company activities.
• Ensures that the development plans are attained by each member of the team.
• Perform tasks that may be assigned from time to time.

Qualifications: 

• At least 3 years work experience in Claims handling
• Proficiency in MS Office
• Excellent Customer Service Orientation
• With Basic LOMA course taken and passed