JOB DUTIES:

• Lead assessment team to gain high work efficiency of the objectives as claim productivity, quality, and TAT service;
• Lead assessment team to do Direct Billing Service smoothly;
• Contribute initiates to develop/ enhance claim system;
• Participate to review and standardize claim procedure, esp. assessment procedure to align with Group claim procedure and increase the efficiency;
• Join the meeting to report to Group/ GARO quarterly;
• Join Claims Committee Meeting quarterly;
• Responsible to follow Claim Report, analyze claim trends to escalate promptly to Claims Management if having abnormal trend as fraud/ abuse trend, … and give the solution and implement the ways to treat them;
• Manage complaints/ enquiries of customers or agents related to claim decisions. Review appeal claims, give decision or propose the solution to Claim Head. Co-operate with Administration Team / Complaint Handling Team in response to customers/ agents;
• Cross function: co-operative closely with other departments: with Compliance in controlling the risks, educate Sales Force, contribute claims experience in building new products, co-operate with actuary to control A/E, claim loss…
• Responsible for training and development claim assessors, build a professional assessment team, apply SOHI culture in work, build an engaged team.

JOB REQUIREMENTS:

1) Education:

• University degree
• Medical, law or economic background is preferred
• Additional Qualifications such as LOMA, English

2) Experience:

• At least 3-year experience in claim assessment field, and
• At least 1-year experience in management role

3) Skills:

• High level of integrity
• Expertise in insurance field, strong analytical, assess and communication skills
• Law and medical knowledge
• Knowledge in computer software and using computer system
• Negotiation skill
• Fluent English communication
• Good initiate and innovation
• High commitment and self-motivation
• Have ability to organize the work and work under high pressure
• Positive attitude. High team-work spirit and human touch