Claim Processing Specialist

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Working Days & Hours: Mon - Fri, 9am - 6pm

Assess and approve personal accident claims accurately within established turnaround times, in line with policy provisions and authority limits.

Evaluate medical, financial and supporting claim documentation, ensuring appropriate claim decisions and reserve adequacy.

Manage claim investigations, including clarification with medical institutions, policyholders, and internal stakeholders.

Review of pending claims to ensure timely resolution and proper closure.

Identify claim patterns and unusual or inappropriate practices and recommend improvements to strengthen claims controls and streamline claim processes.

Collaborate with medical institutions, policyholders, and internal stakeholders to gather and clarify clinical i...