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Associate - Claim Recovery
2 months ago
At Great Eastern, Claims is not just about processing, it fulfils an important role on providing best customer experience to our policyholders.
Health insurance is a major focus for the organisation and in this role, you will formulate strategies and drive initiatives to improve Third Party Claims Recovery rate to support the individual health insurance business. You will also coordinate, investigate, and recover claims by pursuing the responsible third party and assist in providing service to policyholders/ customers through subrogation efforts. Our goal is to identify and employ confident, self-starting, highly motivated individuals who display high-energy and intelligence to achieving our departmental financial objectives. As member of Health Claim Services Department, you will put your investigative and analytic skills to work; communicating with policyholders, medical professionals, hospitals and others to gather the critical information necessary for the prompt, fair and equitable resolution of different types of claims recovery.
The Job
- Demonstrate technical proficiency in resolving recovery of claims and ensure that the recovery target is met
- Engage and communicate with our policyholders to gather information and assist them in claim submission to third party
- Investigate and identify third parties, determine liability, and use all available resources to maximize the recovery
- Notify third party and/ or third party insurance carrier of our subrogation and right of recovery
- Make appropriate referrals to legal counsel to initiate litigation or intervene when appropriate
- Post action plan outlining the course of action to bring the subrogation claim to resolution with target dates. Ensure claim file has all documents to support subrogation recovery efforts
- Manage a timely diary and follow up system on case assignments. Create a recovery log with an estimation of the dollars expected to recover
- Use sound communication skills to successfully negotiate recoveries with third parties
- Update files and provide comprehensive reports as required. Adhere to instructions in recovery efforts, status updates and notification of final disposition
- Take accountability in considering business and regulatory compliance risks and take appropriate steps to mitigate the risks
- Maintain awareness of industry trends on regulatory compliance, emerging threats and technologies in order to understand the risk and better safeguard the company
- Highlight any potential concerns/ risks and proactively share best risk management practices
Our Requirements
- Diploma or Bachelor's Degree, insurance qualifications or equivalent experience preferably 1 year of insurance claims recovery and/ or claim operations experience
- Prior experience in customer service will be an added advantage
- Knowledge of life insurance policy coverage, statutes, regulations and subrogation processing is a plus
- Good verbal and written communication skills
- Team player as well as capable of individual performance
- Excellent organizational and time management skills
- Good interpersonal, analytical and negotiation abilities required
- High level of integrity, take accountability of work and good attitude over teamwork
- Take initiative to improve current state of things and adaptable to embrace new changes
Established in 1908, Great Eastern places customers at the heart of everything we do. Our legacy extends beyond our products and services to our culture, which is defined by our core values and how we work. As champions of Integrity, Initiative and Involvement, our core values act as a compass, guiding and inspiring us to embrace the behaviours associated with each value, upholding our promise to our customers - to continue doing our best for them in a sustainable manner.
We work collaboratively with our stakeholders to look for candidates who exhibit or have the potential to embrace our core values and associated behaviours, as these are the key traits that we expect from our employees as they develop their careers with us.
We embrace inclusivity, giving all employees an equal opportunity to shine and play their role in exploring possibilities to deliver innovative insurance solutions.
Since 2018, Great Eastern has been a signatory to the United Nations (UN) Principles of Sustainable Insurance. Our sustainability approach around environmental, social, and governance (ESG) considerations play a key role in every business decision we make. We are committed to being a sustainability-driven company to achieve a low-carbon economy by managing the environmental footprint of our operations and incorporating ESG considerations in our investment portfolios; improving people's lives by actively helping customers live healthier, better and longer; and drive responsible business practices through material ESG risk management.
To all recruitment agencies: Great Eastern does not accept unsolicited agency resumes. Please do not forward resumes to our email or our employees. We will not be responsible for any fees related to unsolicited resumes.
