Job Purpose

Access and approve claim applications to deliver the claim approval with the service level agreement.

Review and consider each claim request for the condition of claimant with respect to the possibility of loss and preexisting of impairment , assess the indemnity or exclusion condition , and calculate for claim benefit reimbursement per the coverage limit of each policy.

Key Responsibilities:

• Assess and approves wit respect to new incontestable health and accident claim cases regarding the given authority.
• Facilitate the recommendation to higher authority assessor.
• Captures the claim information and benefit payment into the system as required to ensure the accurate payment to the claimant.
• Monitor and take action on self pending of claim ever 15 days.
• Participate into system and process improvement or other assignments from managers to deliver results as expected with the timeline.
• Make commitment of personal development plan and deliver as promised.
• Engage with the company activities and contributes as a good team player to deliver the highest team performance.

Qualifications

• Bachelor degree or higher
• More than 1 year experiences in Cliam Assessor role
• Functional Competency Strong analytical skills, including the ability to detect and report on fraud trends and to identify ways to improve fraud detection, prevention and avoidance.
• Good command of English
• Knowledge in Life insurance product, process and regulation, Posses Medical, litigation, or investigation experiences, Negotiation, Training, Initiative and Team work skill, Customer service orientation, Effective problem solving, Reliability and Accountability, Stress tolerance under pressure