
Claim Executive
1 week ago
Manage claims from registration to finalization with high accuracy in a timely manner;
- Identify reasons why policy conditions are 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 claim;
- Detailed knowledge of Work Injury legislation;
- Assess claims in line with the policy/ statutory limits;
- Investigate the cause of loss ensuring it falls under policy coverage;
- 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 insurance claims
- Strong self-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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