Claims Assessor

Job Overview

We are seeking a highly skilled and detail-oriented professional to join our Life Claims team as a Senior Claims Assessor. This role is critical in ensuring the accurate and timely assessment of legitimate life insurance claims, while upholding the highest standards of service and compliance. The role will also be given the opportunity to be part of an exciting team with involvement in service excellence initiatives and projects to improve the claims experience.

• Manage and assess life claims, including appeals with sound medical knowledge and adherence to policy terms.
• Ensure timely and accurate claim decisions in line with service standards, regulatory requirements and legal matters.
• Engage with medical professionals, hospitals, policyholders and claimants to obtain necessary documentation and clarify clinical details for claim evaluation to achieve timely closure and resolution.
• Deliver excellent service and enhance customer and distribution channels relationship management.
• Collaborate with internal stakeholders to improve claims processes and contribute to continuous improvement initiatives.
• Mentor and guide junior staff.
• Undertake additional responsibilities as assigned by the supervisor, demonstrating flexibility and commitment to organizational needs.
• Take accountability in considering business and regulatory compliance risks and takes appropriate steps to mitigate the risks.
• Maintain awareness of industry trends on regulatory compliance, emerging threats and appropriate steps to mitigate the risks.
• Highlight any potential concerns/risks and proactively shares best risk management practices.

• Degree with at least 8 years of experience in life claims assessment or with relevant experience.
• LOMA (ALMI Level) and ICA Associate certifications are required.
• Strong understanding of medical terminology including ICD and CPT codes, life insurance claim practices and insurance policies.
• Excellent communication and stakeholder management skills.
• Strong analytical, meticulous and good problem-solving skills.
• A positive and motivated individual who is customer-centric and meticulous with the ability to work under pressure.
• A team player.
• Good business acumen with long term vision.
• High level of integrity, takes accountability of work and good attitude over teamwork.
• Take the initiative to improve the current state of things and adapt 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.

• Mid-Senior level

• Full-time

• Administrative
• Industries: Insurance

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