Specialist - Claims Payment (direct health claim)
ที่อลิอันซ์ อยุธยา ประกันชีวิต จำกัด (มหาชน)The position is responsible for managing end-to-end claims processing, including registering claims, verifying documentation, assessing policy coverage, and approving claim payments within assigned authority. The role requiresdirect hands-on experience in claims assessment and payment, ensuring accuracy, compliance, and a high standard of customer service throughout the claims journey.
Key Responsibilities
- Register and open claim cases received from members and healthcare providers
- Verify completeness and accuracy of claim documentation in accordance with company standards
- Assess policy coverage, benefit entitlements, and claim eligibility based on policy terms and conditions
- Approve claim payments within delegated authority limits using professional judgment and experience
- Coordinate with internal stakeholders (e.g., Underwriting, Provider Network) and external parties (hospitals, service providers) to obtain required information
- Ensure all claim records and processing activities are accurately captured in the Claims Management System in a timely manner
- Communicate claim status updates clearly and professionally to customers and providers
- Support quality assurance activities and contribute to continuous improvement initiatives within claims operations
- Perform other duties as assigned
- Bachelor's degree in public health, Medical Technology, or related fields
- Background in the insurance industry is preferred
- Minimum 2 years ofdirect experience in claims registration, assessment, or related claims functions
- Proven capability to handle claims processing independently and accurately within defined authority limits
- Strong technical knowledge of claims processes, policy coverage, and benefits
- High attention to detail with strong analytical and problem-solving skills
- Effective communication and stakeholder management abilities
- Ability to work efficiently in a fast-paced operational environment
- Commitment to delivering excellent customer experience
- Any AI-future skills e.g., ChatGPT, or CoPilot365, will be advantage
Join us. Let's care for tomorrow.
ประสบการณ์ที่จำเป็น
- 2 ปี
เงินเดือน
- สามารถต่อรองได้
สายงาน
- การเงิน
- บริการลูกค้า
- งานธุรการ
ประเภทงาน
- งานประจำ
เกี่ยวกับบริษัท
When people talk about INSURANCE they talk about Allianz Ayudhya COME JOIN US! As Thailand's largest public life insurance joint venture company Allianz Ayudhaya, we are committed to providing people with financial services and products that best service their needs. With over 60 years of exp ...
ร่วมงานกับเรา: Allianz Ayudhya Assurance Pcl. is committed to creating work opportunities and building a high performance culture that not only upholds the company’s core policies but also develops each and every employee’s capabilities. We have acquired a wide range of compensations and benefits fo ...
สวัสดิการ
- ประกันทันตกรรม
- ส่วนลดพนักงาน
- ทำงาน 5 วัน/สัปดาห์
- ชั่วโมงทำงานยืดหยุ่น
- ประกันสุขภาพ
- ประกันสังคม
- ประกันชีวิต
- สมาชิกฟิตเนส
