Claims Examiner Executive, Non-Motor

• Identifying and proposing enhancements for both processing and system functionalities of Non-motor Claims in the endeavor of ensuring an effective claims processing
• Collaborate with IT, vendors, and end-users from various departments to define requirements, testing scopes, and execute user acceptance tests for system enhancements.
• Evaluating, processing, and managing insurance claims to ensure accuracy, adherence to policy terms, and timely resolution. Key responsibilities include:

• Claim Review: Analyzing claims to determine coverage eligibility, policy terms, and applicable deductibles.
• Documentation: Gathering and reviewing claim documentation, such as incident reports, medical records, photographs, and other evidence.
• Coverage Determination: Assessing policy coverage to determine whether the claim falls within the scope of the policy and its limitations.
• Adjudication: Making final decisions on claim settlements and payments based on policy terms, investigation results, and legal considerations.
• Negotiation: Engaging in negotiations with claimants, policyholders, and other relevant parties to settle claims and address any disputes.
• Communication: Effectively communicating with claimants, policyholders, agents, and legal representatives to provide updates on claim status, request additional information, and address inquiries.
• Fraud Detection: Identifying and flagging potentially fraudulent claims and working with investigative teams to mitigate fraud risk.
• Customer Service: Providing high-quality customer service by addressing claimants' concerns, answering questions, and guiding them through the claims process.
• Monitor outstanding claims files, ensure proper claims management by service providers i.e. Adjuster, Surveyors, Lawyers etc.
• Attend to claims related queries and discussions with customers, agents, brokers, sales and any other stakeholders.
• Offer insights from claims perspective to support business acquisition and product development efforts and conduct necessary claims training for relevant stakeholders whenever required.

• Bachelors’ Degree or equivalent, in any related field.
• Fresh graduates are welcome to apply.
• Possessing working experience in system enhancement projects in financial institutions will be advantageous.
• Possessing working experience in claim processing will be advantageous.
• Able to work independently and as a team player.
• Good communication skills.
• Ability to leverage AI tools like ChatGPT for data analysis and generating actionable insights.

Allianz