Senior Officer, Major Claims

We are seeking a Senior Officer, Major Claims to join our team in Kuala Lumpur.

As a Senior Officer, Major Claims, you will assess cases with a main focus on major claims, assist in higher approval of claims exceeding assessors' authority, provide enquiry support, take part in departmental projects, and supervise subordinates in handling daily operations.

Key responsibilities include:

• Following up on additional supporting documents to facilitate decision-making on underwriting, compliance, and premium financing after case submission
• Preparing and checking decline/after-investigation letters
• Approving clean claims, including cross-checking benefit calculations and following up with customer service teams
• Approving non-clean claims, including cross-checking benefit calculations and following up with customer service teams
• Conducting claims investigations
• Preparing tailored letters, including decision and investigation letters
• Handling ad-hoc assignments from management
• Handling claims appeal cases/complaint cases related to claims
• Providing support to minor and pre-authorisation cases if needed
• Conducting training for internal staff and/or agents
• Handling enquiries and complaints from customers, agents, and internal staff
• Training new staff to obtain claims authority
• Reviewing escalated cases from junior staff