Analyst, Claims
aia · Myanmar, MM - AIA Myanmar ·
Processes and adjudicates insurance claims, reviews medical documents, and resolves customer complaints to ensure timely, compliant service delivery in healthcare insurance.
At AIA we’ve started an exciting movement to create a healthier, more sustainable future for everyone.
It’s about finding new ways to not only better people's lives, but to better the communities and environments we live in. Encompassing our ambition of helping a billion people live Healthier, Longer, Better Lives by 2030.
And to get there, we need ambitious people who believe in playing an important part in shaping that future. People seeking unmatched career and personal growth opportunities, who are driven to work with, and learn from some of the most inspiring and supportive leaders in the business.
Sound like you? Then read on.
About the Role
He/she is responsible for the daily operations of all Claims and Customer Care related functions which includes among others after sales service, managing all the incoming and out-going calls to ensure customers are impressed with our services at all time.This position is operationally responsible for ensuring the day to day Claims and Heath Care services are processed within the guideline, standard and in timely manner.
He/she is to ensure all customer complaints are handled and resolved speedily to improve processes and communications.
He/she is to ensure successful deliveries of the BAU activities with quality and are in compliance with the internal and external regulatory guideline and requirements.
Assess and settle insurance claims arising from policies in force and answer inquiries relating to claims processing and payment.
Process all insurance claims documents timely and make recommendations and guidelines to insurance claims
To ensure cases are follow-up and follow through within the service standard
To carry out day to day transactions and approve based on the approved authority limits.
To perform data entry and or amendments as and when required.
To prepare daily statistics within the agreed timeline and ensure cases are managed by the respective team member for closure.
To update SOP (STANDARD OPERATING PROCEDURE) and ensure the updated is reviewed by the authorized parties timely.
To support all team members and testing for system enhancements as and when required.
To conduct Training, Learning and SME knowledge Sharing to team members or other department in areas of expertise.
Actively participate in and contribute to projects and initiatives and support all new projects of operations including customer care and system enhancements.
Determine eligible benefits based on documents submitted and policy provisions.
Adjudicate claims and determine corresponding recommendation or decision within prescribed approval limits and within the defined turnaround time.
Assist the Team in resolving claims-related complaints/issues and/or concerns.
Discuss claim decisions with Management whenever necessary.
Minimum Job Requirements:
Preferably bachelor’s degree holder related to any medical course.
Strong ability of understanding medical terminologies in analyzing and reviewing medical cases.
Good team player with strong analytical, interpersonal and communication skills and ability to work under pressure.
Able to handle conflicts and self-motivated in difficult situations with good customer service orientation.
Displays high learning orientation, innovation, and motivation to achieve target goals.
Knowledge in claims processing is a plus.
Literacy in both English and Burmese, both verbal & written.
Build a career with us as we help our customers and the community live Healthier, Longer, Better Lives.
You must provide all requested information, including Personal Data, to be considered for this career opportunity. Failure to provide such information may influence the processing and outcome of your application. You are responsible for ensuring that the information you submit is accurate and up-to-date.