Executive, Claims Investigator (Non-Motor) | Kuala Lumpur, MY

Summary

We are seeking a highly skilled professional to join our Claims Control & Specialised Claims Unit. As a key member of our team, you will be responsible for Market Intelligence, serving as a Claims Specialist, overseeing Performance Management, and handling Fraud Management. Your expertise will ensure efficient and effective claims processing while safeguarding against fraudulent activities. If you're passionate about claims and have a keen eye for detail, we want to hear from you!

Responsibilities:

• To perform and/or oversee the following duties and responsibilities within the department:
• Regular review of open files in order to identify root causes of claims leakage and the translation of those findings into action plans to reduce leakage through process improvements and/or training.
• To manage the specialised claims from point of notification up to settlement i.e. manage the progress of Adjusters investigation.
• Periodic monitoring outstanding claim files with Adjusters.
• Review work processes and provide solutions in improvement of claim guidelines and work processes.
• To assist in department's administrative works, systems and procedures for smooth operations and continuous improvement.
• Performs investigation of potential fraud cases to uncover the fraud pattern and also the parties involved.
• Developing claim reviews plans (including outstanding and closed cases).
• Review, investigate and actively involved in all complex and contentious claims referred to the team to ensure compliance with policy requirements and smooth settlement.
• Analyses and maintains an up-to-date knowledge and data of fraud trends in the market.
• Backup team members and assume the responsibilities as and when required.
• Perform other duties as delegated by the Management.
• Ensure compliance to policies, guidelines and regulations.

• At least 3 years of experience in the insurance claims industry, with a focus on fire /engineering and other non-motor cases.
• Strong understanding of insurance policies and claims processing.
• Excellent communication and negotiation skills.
• Ability to work independently and as part of a team.
• Strong attention to detail and organizational skills.