
Claims Handler/ Senior Claims Handler
7 days ago
The incumbent will be responsible for processing and investigating Work Injury Compensation, Travel or Health claims. This will involve working with the policy holder, Insurers, Brokers, colleagues and other professionals to ensure the claim is valid.
**Main duties**:
- Manage claims from registration to finalisation with high accuracy on a timely manner
- Identify reasons why policy conditions is not applicable
- Correspond with network providers and approved professionals
- Monitor the progress of a claim to assist with quick resolutions
- Investigate potentially fraudulent claims
- Prepare an initial estimate of costs and closely monitor keeping records of costs
- Act on advice from external specialists, such as loss adjusters and forensic accountants, on complex cases
- Ensure fair settlement of a valid claims
- Detailed knowledge of legislative changes
- Assess claims in line with the policy limits
- Investigate cause of loss ensuring it falls under policy coverage
- Medical Claims Knowledge
- Adhere to legal requirements, industry regulations and customer quality standards set by the company
**Requirements**:
- Minimum Diploma or Degree qualification/ or BCP, CGI, PGI
- Minimum 1 year of working experience or experience in handling Health Claims/ WICA claims/ Travel claims
- Initiative and ability to adapt quickly
- Good numeracy and literacy
- Good communication skills (Oral & Written)
- Strong in MS Excel and Powerpoint
- Analytical with attention to details
- Team player
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